Inner Canvas Counseling, PLLC

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

INNER CANVAS COUNSELING, PLLC

Practice address

112 University Dr N Ste 300
Fargo, ND 58102-4661

Phone

(701) 866-7960

NPI assigned

Apr 25, 2018

Last updated

Apr 26, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ashley Stielow, LPCCNPI 1306149323

Title

President

Phone

(701) 866-7960

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ashley Lynn Stielow, LPCC

  • Counselor
  • Fargo, ND
  • NPI 1306149323
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1524614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524700800000",
    "number": "1174011126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 UNIVERSITY DR N STE 300",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581024661",
            "telephone_number": "701-866-7960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 UNIVERSITY DR N STE 300",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581024661",
            "telephone_number": "701-866-7960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNER CANVAS COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-25",
        "last_updated": "2018-04-26",
        "status": "A",
        "authorized_official_last_name": "STIELOW",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-866-7960",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Fargo, ND
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.