Individual provider Active NPI

Alyssa Eppen-Tanem

  • Professional Counselor
  • Jamestown, ND
National Provider Identifier
1477166189
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
520 3Rd St NW
Jamestown, ND 58401-2968
Phone
(701) 253-6300
NPI assigned
Aug 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

520 3Rd St NW
Jamestown, ND 58401-2968

Mailing address

520 3Rd St NW
Jamestown, ND 58401-2968
Phone (701) 253-6300

Other names 1

  • Alyssa Eppen Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240328003881 ND Practitioner - Mental Health Counselor 4385082189 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
South Central Behavioral Health Clinic CurrentSince Jan 18, 2024 Accepting new patients

Locations

520 3rd St NW
Jamestown, ND 58401
Phone (701) 253-6300

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1598227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1477166189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 3RD ST NW",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584012968",
            "telephone_number": "701-253-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 3RD ST NW",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584012968",
            "telephone_number": "701-253-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPPEN-TANEM",
        "first_name": "ALYSSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-24",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "EPPEN",
            "credential": "LPCC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jamestown, ND

Sources for this page

Verify at the official NPI Registry.