Individual provider Active NPI

Emily M Jones, LCSW

  • Clinical Social Worker
  • Fargo, ND
National Provider Identifier
1184142945
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5029 Issued in ND
Practice address
4675 40TH Ave S Ste 120
Fargo, ND 58104-4444
Phone
(701) 715-8567
Fax
(701) 540-0098
NPI assigned
Aug 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 5029 ND Primary

Addresses

Primary practice location

4675 40TH Ave S Ste 120
Fargo, ND 58104-4444

Mailing address

4675 40TH Ave S Ste 120
Fargo, ND 58104-4444
Phone (701) 715-8567

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
I20191218001508 ND Practitioner - Clinical Social Worker 9436583879 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5029NDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Spirit Counseling, PLLC Clinical CurrentSince Jul 25, 2019 Accepting new patients
Solace Counseling PLLC Clinical CurrentSince Apr 1, 2021 Accepting new patients

Locations

1535 42nd St S
Ste 400
Fargo, ND 58103
Phone (701) 715-3183

4675 40th Ave S
Ste 120
Fargo, ND 58104
Phone (701) 715-3183

1321 23rd St S
Ste D
Fargo, ND 58103
Phone (701) 203-8725

Organizations & group practices 2

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": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1184142945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4675 40TH AVE S STE 120",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044444",
            "telephone_number": "701-715-8567",
            "fax_number": "701-540-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4675 40TH AVE S STE 120",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044444",
            "telephone_number": "701-715-8567",
            "fax_number": "701-540-0098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "EMILY",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-31",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "5029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.