Misty Ibach, LAC, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

775-3-1-14-430 Issued in ND

Practice address

1202 23Rd St S
Fargo, ND 58103-2951

Phone

(701) 293-5429

Fax

(701) 293-0736

NPI assigned

Aug 20, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1184090433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 23RD ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032951",
            "telephone_number": "701-293-5429",
            "fax_number": "701-293-0736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 23RD ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032951",
            "telephone_number": "701-293-5429",
            "fax_number": "701-293-0736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBACH",
        "first_name": "MISTY",
        "credential": "LAC, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-20",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ND",
            "license": "1783",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ND",
            "license": "775-3-1-14-430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Huynh
• Andrew James Hvidston, MD
• Roger W Hynes, M.D.
• Cheryl A Hysjulien, PSYD LP
• Ashley Hystead
• Jamal Ibnelhaj, PT
• Ahmed Ali Ibrahiim
• Abdinasir Ali Ibrahim
• Ahmed Ibrahim
• Amal Ali Ibrahim

• Mental Health Counselor in Fargo, ND
• Providers in Fargo, ND by specialty
• Mental Health Counselor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; 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.