Experience Counseling Services
Organization Active NPI Community/Behavioral Health Agency · Fargo, ND
NPI 1194262014 · NPPES record last updated Jan 30, 2017
Key facts
- NPI
- 1194262014
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- License
- 1633 (ND)
- Legal business name
- EXPERIENCE COUNSELING SERVICES
- Practice address
- 3523 45TH St S
Fargo, ND 58104-8962 - Phone
- (701) 639-6561
- NPI assigned
- Jan 30, 2017
- Organization subpart
- No
Authorized official
- Name
- Amanda Rae Decker, LAC
- Title
- Ceo
- Phone
- (701) 639-6561
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 1633 | ND | Yes |
Addresses
Primary practice location
3523 45TH St S
Fargo, ND 58104-8962
Mailing address
3523 45TH St S
Fargo, ND 58104-8962
Phone (701) 639-6561
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 30, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.