Individual provider Active NPI

Kathryn Taylor Wayt, LPCC

  • Professional Counselor
  • Fargo, ND
National Provider Identifier
1538466263
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1062-4-15-20-383 Issued in ND
Practice address
1112 Nodak Dr S
Fargo, ND 58103-2333
Phone
(701) 232-6224
Fax
(701) 232-4687
NPI assigned
Feb 15, 2011
Last updated
Jan 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1062-4-15-20-383 ND Primary

Addresses

Primary practice location

1112 Nodak Dr S
Fargo, ND 58103-2333

Mailing address

1112 Nodak Dr S
Fargo, ND 58103-2333
Phone (701) 232-6224

Other identifiers 1

IdentifierTypeStateIssuer
1479322MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jun 25, 2024 through Jun 25, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Christian Counseling and Wellness Mental Health CurrentSince Apr 19, 2020 Accepting new patients

Locations

1112 Nodak Dr S
Fargo, ND 58103
Phone (701) 232-6224

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": "1297728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1538466263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 NODAK DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032333",
            "telephone_number": "701-232-6224",
            "fax_number": "701-232-4687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 NODAK DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032333",
            "telephone_number": "701-232-6224",
            "fax_number": "701-232-4687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAYT",
        "first_name": "KATHRYN",
        "middle_name": "TAYLOR",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-15",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ND",
            "license": "1062-4-15-20-383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1479322",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.