Amy J Lavalla, DNP, PMHNP-BC, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

CNP 4017 Issued in MN

Practice address

1132 28TH Ave S Ste 102
Moorhead, MN 56560-4420

Phone

(218) 512-0630

NPI assigned

Jul 21, 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

Enrolled in ND, MN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

SLV Group LLCGroup PAC ID 2466821251, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• SLV Group, LLC

  dba Oasis Mental Health and Wellness

  • Psychiatric/Mental Health Nurse Practitioner
  • Moorhead, MN
  • NPI 1285352872
  Medicare reassignment Care Compare group NPD Authorized official
• Cos PLLC

  dba Aurora Mental Health and Wellness

  • Adult Mental Health Clinic/Center
  • Waite Park, MN
  • NPI 1083317812
  Medicare reassignment NPD
• PSJ Acquisition LLC

  dba Prairie St John's

  • Psychiatric Hospital
  • Fargo, ND
  • NPI 1679709802
  Medicare reassignment NPD
• PSJ Acquisition LLC

  dba Prairie St. John's

  • Psychologist
  • Fargo, ND
  • NPI 1720454267
  NPD
• Lakeland Mental Health Center

  • Case Manager/Care Coordinator
  • Fergus Falls, MN
  • NPI 1972950962
  NPD (past)

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

{
    "created_epoch": "1437436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1215312236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1132 28TH AVE S STE 102",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565604420",
            "telephone_number": "218-512-0630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 28TH AVE S STE 102",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565604420",
            "telephone_number": "218-512-0630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVALLA",
        "first_name": "AMY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DNP, PMHNP-BC, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-21",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ND",
            "license": "R37868",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "CNP 4017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Keat Larson, DDS
• Alisson Lass
• Matthew Douglas Lau, D.C.
• Abigail Marie Laubenstein
• Kyley Rae Lauf
• Grace Lawrence
• Kayla Lawrence
• Ingrid Lean
• Melissa A Lee-Eckes, MSW, LICSW
• Brenna Lee

• Psychiatric/Mental Health Nurse Practitioner in Moorhead, MN
• Providers in Moorhead, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.