Alissa Jan Stein Fugazzi, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3664 Issued in ND

Practice address

3001B 32ND Ave S Ste 2B
Grand Forks, ND 58201-6068

Phone

(701) 747-0770

Fax

(701) 425-0524

NPI assigned

Oct 2, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ND

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 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1447447511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001B 32ND AVE S STE 2B",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582016068",
            "telephone_number": "701-747-0770",
            "fax_number": "701-425-0524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001B 32ND AVE S STE 2B",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582016068",
            "telephone_number": "701-747-0770",
            "fax_number": "701-425-0524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUGAZZI",
        "first_name": "ALISSA",
        "middle_name": "JAN STEIN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-02",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "3664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457035",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Fridgen
• Jami Lynn Frize, MA, CCC-SLP
• Tami Froelich
• Greg M Frokjer, DDS
• Kathryn Fruetel
• John B. Fuher, LSW
• John T Fulp, D.C.
• Shelley Jean Fultz, LPN
• Peter A Funk, MD
• Sarah Jeanette Morrill Furlong, PA-C

• Clinical Social Worker in Grand Forks, ND
• Providers in Grand Forks, 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 Apr 6, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.