Mary Reiten Eylands, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

505-3-15-04-166 Issued in ND

Practice address

600 Demers Ave
US Bank Building - Suite 404
Grand Forks, ND 58201-4599

Phone

(701) 746-4400

Fax

(701) 746-6034

NPI assigned

Sep 21, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Center for Self-Growth & Renewal, PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Grand Forks, ND
  • NPI 1265658967
  NPD (past)

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

{
    "created_epoch": "1253491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253491200000",
    "number": "1285968404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 DEMERS AVE",
            "address_2": "US BANK BUILDING - SUITE 404",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014599",
            "telephone_number": "701-746-4400",
            "fax_number": "701-746-6034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 DEMERS AVE",
            "address_2": "US BANK BUILDING - SUITE 404",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014599",
            "telephone_number": "701-746-4400",
            "fax_number": "701-746-6034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EYLANDS",
        "first_name": "MARY",
        "middle_name": "REITEN",
        "name_prefix": "Ms.",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-21",
        "last_updated": "2009-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ND",
            "license": "505-3-15-04-166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Professional Counselor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2009; 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.