Active NPI
Mary K Uong-Kaale
- Marriage & Family Therapist
- Fargo, ND
National Provider Identifier
1174839724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 2010-33
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2041 | MN | MD | Marriage & Family Therapist |
| 2010-33 | ND | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Village Family Service Center | Marriage & Family Therapist | Current | Accepting new patients |
| Village Family Service Center | Current | 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Fargo, ND
- NPI 1568492353
Marriage & Family Therapist, ND
-
- Marriage & Family Therapist
- Fargo, ND
- NPI 1619775228
-
- Substance Abuse Rehabilitation Facility
- Fargo, ND
- NPI 1952679318
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.