Amber Nicole Mutalipassi, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

5301 Issued in ND

Practice address

624 Main Ave Ste 3a
Fargo, ND 58103-1966

Phone

(701) 373-1149

NPI assigned

Feb 11, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, ND2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

82.73 of 100Reported as group

Quality

71.75

Promoting interoperability

100

Improvement activities

40

Cost

70.68

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Cornervine Counseling, PLLC

  • Clinical Social Worker
  • Fargo, ND
  • NPI 1184423121
  NPD Authorized official

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

{
    "created_epoch": "1455148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1417316001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 MAIN AVE STE 3A",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031966",
            "telephone_number": "701-373-1149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 MAIN AVE STE 3A",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031966",
            "telephone_number": "701-373-1149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTALIPASSI",
        "first_name": "AMBER",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-11",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ND",
            "license": "5301",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "25046",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "25046",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "5301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Muscha, PHARMD
• Ayub Muse
• Sakshi Muskawad, MD
• Farhad Mustafa
• Dami Mustapha
• Scott Bradley Mutchler, MD
• Sheila Muus, LPC
• My PT, PLLC
• Leslie Anne Myer, OTR/L
• Faith Myers

• 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 Jun 16, 2025; 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.