Individual provider Active NPI

Terrijann Muller Dahlberg, LPCC

  • Professional Counselor
  • Fargo, ND
National Provider Identifier
1487504387
Registry record updated Jan 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1019-8-15-19-507 Issued in ND
Practice address
2701 12TH Ave S
Fargo, ND 58103-8753
Phone
(701) 451-4900
Fax
(651) 925-0057
NPI assigned
Jan 30, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X SUP-LPCC-213 ND
Professional Counselor 101YP2500X 1019-8-15-19-507 ND Primary

Addresses

Primary practice location

2701 12TH Ave S
Fargo, ND 58103-8753

Mailing address

2701 12TH Ave S
Fargo, ND 58103-8753
Phone (701) 451-4900

Other names 1

  • Terrijann Mullerdahlberg Professional 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
I20260330001024 ND Practitioner - Mental Health Counselor 1557846474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Village Family Service CenterGroup PAC ID 7517857428, 27 clinicians

Practice addresses (Care Compare)

2701 12TH Ave S
Fargo, ND 58103-8753
Phone (701) 451-4900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SUP-LPCC-213NDMDProfessional Counselor

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": "1769731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769731200000",
    "number": "1487504387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 12TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581038753",
            "telephone_number": "701-451-4900",
            "fax_number": "651-925-0057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 12TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581038753",
            "telephone_number": "701-451-4900",
            "fax_number": "651-925-0057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLER DAHLBERG",
        "first_name": "TERRIJANN",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-30",
        "last_updated": "2026-01-30",
        "certification_date": "2026-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ND",
            "license": "SUP-LPCC-213",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ND",
            "license": "1019-8-15-19-507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERRIJANN",
            "last_name": "MULLERDAHLBERG",
            "credential": "PSY.D, PHD, LPCC-S",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.