Individual provider Active NPI

Melissa Jeanette Reinhart Kornkven, LMSW

  • Social Worker
  • Fargo, ND
National Provider Identifier
1528809407
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6689 Issued in ND
Practice address
5354 42ND St S Ste B
Fargo, ND 58104-4032
Phone
(701) 941-4503
NPI assigned
Jun 4, 2024
Last updated
Aug 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6689 ND
Social Worker 104100000X 6689 ND Primary

Addresses

Primary practice location

5354 42ND St S Ste B
Fargo, ND 58104-4032

Mailing address

517 East St
Bottineau, ND 58318-1425
Phone (701) 871-7066

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

LicenseStateTypeSpecialty
6689NDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates Counseling Wi., S.C. CurrentSince Jun 9, 2024 Accepting new patients

Locations

5354 42nd St S
Ste B
Fargo, ND 58104
Phone (701) 501-8014

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, 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": "1717459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1528809407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 EAST ST",
            "city": "BOTTINEAU",
            "state": "ND",
            "postal_code": "583181425",
            "telephone_number": "701-871-7066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5354 42ND ST S STE B",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044032",
            "telephone_number": "701-941-4503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNKVEN",
        "first_name": "MELISSA",
        "middle_name": "JEANETTE REINHART",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-04",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "6689",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ND",
            "license": "6689",
            "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 Aug 4, 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.