Entwine, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

ENTWINE, LLC

Practice address

4342 15TH Ave S Ste 103
Fargo, ND 58103-1125

Phone

(701) 532-0991

Fax

(701) 532-0428

NPI assigned

Apr 8, 2021

Reactivated

Nov 13, 2023

Last updated

Nov 13, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Chasity Marie Keller, LCSW

Title

Clinical Social Worker

Phone

(701) 532-0991

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brian D Anderson, LMSW

  • Mental Health Counselor
  • Fargo, ND
  • NPI 1831959741
  NPD
• Laura Howery Siercks, LICSW

  • Clinical Social Worker
  • Minot, ND
  • NPI 1134217748
  NPD (past)

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

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699833600000",
    "number": "1407436173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4342 15TH AVE S STE 103",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031125",
            "telephone_number": "701-532-0991",
            "fax_number": "701-532-0428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4342 15TH AVE S STE 103",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031125",
            "telephone_number": "701-532-0991",
            "fax_number": "701-532-0428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENTWINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-08",
        "last_updated": "2023-11-13",
        "certification_date": "2023-08-24",
        "deactivation_date": "2023-09-07",
        "reactivation_date": "2023-11-13",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "CHASITY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "701-532-0991",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula Renee Ennis
• Michelle I Enockson, OT
• Roger Tambe Enow Tambe
• Angela Marie Ensrud, SOLE PROPRIETOR
• Taylor N Ensrude, DDS
• Erica Entzminger, M.S. CCC-SLP
• Brittany Enzminger
• Mary Katharine Epping, LAC, LCSW
• Elizabeth Erber
• Adrienne Erdmann

• Clinical Social Worker in Fargo, ND
• Providers in Fargo, ND by specialty
• Clinical Social Worker in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.