Individual provider Active NPI

Brittany Van Der Watt, MSW, LGSW

  • Clinical Social Worker
  • Fargo, ND
National Provider Identifier
1205644796
Registry record updated Feb 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
26809 Issued in MN
Practice address
4342 15TH Ave S
Fargo, ND 58103-1100
Phone
(218) 227-5503
Fax
(218) 227-5506
NPI assigned
Dec 30, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2026

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 26809 MN Primary

Addresses

Primary practice location

4342 15TH Ave S
Fargo, ND 58103-1100

Mailing address

4342 15TH Ave S
Fargo, ND 58103-1100
Phone (218) 227-5503

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Beths Place Medication Management LLC PastSince Jan 5, 2025 Accepting new patients
Four Elements Therapy PLLC Clinical Past Accepting new patients

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": "1735516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771545600000",
    "number": "1205644796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4342 15TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031100",
            "telephone_number": "218-227-5503",
            "fax_number": "218-227-5506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4342 15TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031100",
            "telephone_number": "218-227-5503",
            "fax_number": "218-227-5506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DER WATT",
        "first_name": "BRITTANY",
        "credential": "MSW, LGSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-30",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "26809",
            "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 20, 2026; 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.