Individual provider Active NPI

Mary K Uong-Kaale

  • Marriage & Family Therapist
  • Fargo, ND
National Provider Identifier
1174839724
Registry record updated Feb 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2010-33 Issued in ND
Practice address
1201 25TH St S
Fargo, ND 58103-2311
Phone
(701) 451-4900
NPI assigned
Aug 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 2041 MN
Marriage & Family Therapist 106H00000X 2010-33 ND Primary

Addresses

Primary practice location

1201 25TH St S
Fargo, ND 58103-2311

Mailing address

PO Box 9859
Fargo, ND 58106-9859
Phone (701) 451-4900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240122000681 ND Practitioner - Marriage and Family Therapist 3971955303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Village Family Service Center 27 clinicians

Practice addresses (Care Compare)

2701 12TH Ave S
Fargo, ND 58103-8753
Phone (701) 451-4900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2041MNMDMarriage & Family Therapist
2010-33NDMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Village Family Service Center Marriage & Family Therapist CurrentSince Jan 1, 2024 Accepting new patients
Village Family Service Center CurrentSince Jan 1, 2024 Accepting new patients
Sunset Therapy Wheel PLLC Marriage & Family Therapist Current Accepting new patients

Locations

1201 25th St SW
Fargo, ND 58103
Phone (701) 451-4855

2701 12th Ave S
Fargo, ND 58103
Phone (701) 451-4865

20 1st St SW
Ste 250
Minot, ND 58701
Phone (701) 852-3328

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1282262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1174839724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9859",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581069859",
            "telephone_number": "701-451-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 25TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032311",
            "telephone_number": "701-451-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UONG-KAALE",
        "first_name": "MARY",
        "middle_name": "K",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-20",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2041",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "ND",
            "license": "2010-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.