Organization Active NPI

Susan Delap, MD, Professional Corporation

Doing business as A Balanced Mind Psychiatric Wellness Center

  • Adult Mental Health Clinic/Center
  • Bismarck, ND
National Provider Identifier
1336454438
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
SUSAN DELAP, MD, PROFESSIONAL CORPORATION
Doing business as
A Balanced Mind Psychiatric Wellness Center
Practice address
4023 State St
Suite 100
Bismarck, ND 58503-0690
Phone
(701) 751-3737
Fax
(701) 751-3738
NPI assigned
Aug 12, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Susan Eileen Delap, M.D.NPI 1396809919
Title
Owner
Phone
(701) 751-3737

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X
Adult Mental Health Clinic/Center 261QM0850X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X 8942 ND

Addresses

Primary practice location

4023 State St
Suite 100
Bismarck, ND 58503-0690

Mailing address

PO Box 7010
Bismarck, ND 58507-7010
Phone (701) 751-3737

Other identifiers 2

IdentifierTypeStateIssuer
21502OtherNDBLUE CROSS BLUE SHIELD
11796MedicaidND

Other names 1

  • A BALANCED MIND PSYCHIATRIC WELLNESS CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100831000405 ND Part B Supplier - Clinic/Group Practice 7810011681 Receives reassigned benefits from 1 practitioner
Practice locations: Bismarck, ND

National Provider Directory

National Provider Directory

Locations

1720 Burnt Boat Dr
Ste 205
Bismarck, ND 58503
Phone (701) 255-0533

4023 State St
Ste 100
Bismarck, ND 58503
Phone (701) 751-3737

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1281571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1336454438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7010",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585077010",
            "telephone_number": "701-751-3737",
            "fax_number": "701-751-3738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4023 STATE ST",
            "address_2": "SUITE 100",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585030690",
            "telephone_number": "701-751-3737",
            "fax_number": "701-751-3738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN DELAP, MD, PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-12",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "DELAP",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "EILEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-751-3737",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "ND",
            "license": "8942",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "21502",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11796",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A BALANCED MIND PSYCHIATRIC WELLNESS CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.