Individual provider Active NPI

Alexis Nicole Miller

  • Mental Health Counselor
  • Fargo, ND
National Provider Identifier
1508749789
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1469-7-15-25A Issued in ND
Practice address
4610 Amber Valley Pkwy S Ste F
Fargo, ND 58104-8621
Phone
(701) 258-3780
NPI assigned
Jul 28, 2025
Last updated
Jul 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 1469-7-15-25A ND Primary

Addresses

Primary practice location

4610 Amber Valley Pkwy S Ste F
Fargo, ND 58104-8621

Mailing address

1521 1St Ave N Apt 411
Moorhead, MN 56560-2265
Phone (701) 412-1264

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvation Health Services P.C. Mental Health CurrentSince Aug 3, 2025 Accepting new patients
Becoming Balanced PC Multi-Specialty PastSince Aug 3, 2025 Accepting new patients

Locations

4610 Amber Valley Pkwy S
Ste F
Fargo, ND 58104
Phone (701) 258-3780

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1753660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1508749789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 1ST AVE N APT 411",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565602265",
            "telephone_number": "701-412-1264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4610 AMBER VALLEY PKWY S STE F",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048621",
            "telephone_number": "701-258-3780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ALEXIS",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-28",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "ND",
            "license": "1469-7-15-25A",
            "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 Jul 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.