Individual provider Active NPI

Miracle Raye Hoff, LPCC

  • Professional Counselor
  • Fargo, ND
National Provider Identifier
1548308919
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
537-9-15-05-254 Issued in ND
Practice address
4357 13TH Ave S Ste 104
Fargo, ND 58103-7504
Phone
(701) 478-4480
Fax
(701) 478-4481
NPI assigned
Feb 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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 01726 MN
Professional Counselor 101YP2500X 537-9-15-05-254 ND Primary

Addresses

Primary practice location

4357 13TH Ave S Ste 104
Fargo, ND 58103-7504

Mailing address

4357 13TH Ave S Ste 104
Fargo, ND 58103-3381
Phone (701) 478-4480

Other names 1

  • Miracle Raye Haase Former name

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
01726MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Insight Behavioral Health Partners CurrentSince Jul 1, 2022 Accepting new patients

Locations

4357 13th Ave S
Ste 104
Fargo, ND 58103
Phone (701) 306-8369

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": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1548308919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4357 13TH AVE S STE 104",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033381",
            "telephone_number": "701-478-4480",
            "fax_number": "701-478-4481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4357 13TH AVE S STE 104",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581037504",
            "telephone_number": "701-478-4480",
            "fax_number": "701-478-4481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFF",
        "first_name": "MIRACLE",
        "middle_name": "RAYE",
        "name_prefix": "Mrs.",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "01726",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ND",
            "license": "537-9-15-05-254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIRACLE",
            "last_name": "HAASE",
            "middle_name": "RAYE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Nov 22, 2024; 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.