Active NPI
Shanda Hakk
- Social Worker
- Fargo, ND
National Provider Identifier
1477809234
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 4182
- Practice address
- 3911 20TH Ave S
Fargo, ND 58103-4705 - Phone
- (701) 391-9961
- NPI assigned
- Jul 31, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 4182 | ND | Primary |
Addresses
Primary practice location
3911 20TH Ave S
Fargo, ND 58103-4705
Mailing address
1112 Nodak Dr S Ste 200
Fargo, ND 58103-2366
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4182 | ND | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588636800000",
"number": "1477809234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1112 NODAK DR S STE 200",
"city": "FARGO",
"state": "ND",
"postal_code": "581032366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3911 20TH AVE S",
"city": "FARGO",
"state": "ND",
"postal_code": "581034705",
"telephone_number": "701-391-9961"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAKK",
"first_name": "SHANDA",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-07-31",
"last_updated": "2020-05-05",
"certification_date": "2020-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ND",
"license": "4182",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.