Cornervine Counseling, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

CORNERVINE COUNSELING, PLLC

Practice address

624 Main Ave Ste 3a
Fargo, ND 58103-1966

Phone

(701) 373-1149

NPI assigned

Mar 11, 2025

Organization subpart

No

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

Authorized official

Name

Amber Mutalipassi, LCSWNPI 1417316001

Title

Owner

Phone

(701) 773-3381

Specialties & licenses 1

Addresses

Locations

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.

• Amber Nicole Mutalipassi, LCSW

  • Clinical Social Worker
  • Fargo, ND
  • NPI 1417316001
  NPD Authorized official

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

{
    "created_epoch": "1741651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743033600000",
    "number": "1184423121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 MAIN AVE STE 3A",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031966",
            "telephone_number": "701-373-1149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 MAIN AVE STE 3A",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031966",
            "telephone_number": "701-373-1149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERVINE COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-11",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A",
        "authorized_official_last_name": "MUTALIPASSI",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-773-3381",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie J Corneliussen, PSYD
• Corner Medical LLC (Corner Home Medical)
• Cornerstone Caregiving East LLC
• Cornerstone Dental Group LLC
• Cornerstone Residential Services
• Amanda J Coronato, OTR/L
• Kennedy Correa
• Mellisa Cortright
• Erica Cossette
• Jason Cossette

• Clinical Social Worker in Fargo, ND
• Providers in Fargo, ND by specialty
• Clinical Social Worker in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; 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.