Ampha Farah – Behavior Analyst in Moorhead, MN

Key facts

NPI: 1548073885
Entity type: Individual (NPI type 1)
Primary specialty: Behavior Analyst 103K00000X
Practice address: 1132 28TH Ave S Ste 101a
Moorhead, MN 56560-4420
Phone: (612) 443-9032
NPI assigned: Jan 30, 2025
Sex: Female
Sole proprietor: No

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.

Wise Wellness Center LLC Clinic/Center · Moorhead, MN · NPI 1649033705

NPD

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Practice roles

Organization	Specialty	Status	New patients
Wise Wellness Center LLC		Current since Feb 2, 2025	Accepting new patients

Locations

1132 28th Ave S
Ste 101A
Moorhead, MN 56560
Phone (612) 443-9032

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Behavior Analyst	103K00000X			Yes

Addresses

Primary practice location

1132 28TH Ave S Ste 101a
Moorhead, MN 56560-4420

Mailing address

1132 28TH Ave S Ste 101a
Moorhead, MN 56560-4420

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 30, 2025.

{
    "created_epoch": "1738195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1548073885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1132 28TH AVE S STE 101A",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565604420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 28TH AVE S STE 101A",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565604420",
            "telephone_number": "612-443-9032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARAH",
        "first_name": "AMPHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-30",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorhead, MN

All providers in Moorhead, MN · Behavior Analyst in Minnesota

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 30, 2025. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.