Jennifer Landphere, B.S., LAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1510 Issued in ND

Practice address

409 7TH St S
Fargo, ND 58103-1821

Phone

(701) 293-3384

Fax

(701) 293-3759

NPI assigned

Jan 22, 2007

Sex

Female

Sole proprietor

No

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

Credentials

Bachelor of Science

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 and National Provider Directory roles.

• Goodclover, LLC

  • Substance Abuse Rehabilitation Facility
  • West Fargo, ND
  • NPI 1184247975
  NPD Authorized official

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279497600000",
    "number": "1417001033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 7TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031821",
            "telephone_number": "701-293-3384",
            "fax_number": "701-293-3759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 7TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031821",
            "telephone_number": "701-293-3384",
            "fax_number": "701-293-3759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDPHERE",
        "first_name": "JENNIFER",
        "credential": "B.S., LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2010-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ND",
            "license": "1510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Barrett Landauer, PHD
• Nicole Landen, CRNA
• Joshua Landis, LBSW
• Katelynn Landis
• Kaitlin Landowski, DC
• Monica Landry, DC
• Zachary Landry
• Hannah Laney
• Alexandra Lang, PHARMD
• Breanna Kay Lang

• All providers in Fargo, ND
• Addiction (Substance Use Disorder) Counselor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2010; 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.