Monique Alexandra Pederson

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

835-6-1-15-313 Issued in ND

Practice address

919 S 7TH St Ste 303
Bismarck, ND 58504-5835

Phone

(701) 712-3290

NPI assigned

Jun 2, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Vitality Mental Health, PLLC

  • Mental Health Counselor
  • Bismarck, ND
  • NPI 1578168993
  NPD Authorized official

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1548640956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 S 7TH ST STE 303",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585045835",
            "telephone_number": "701-712-3290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 S 7TH ST STE 303",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585045835",
            "telephone_number": "701-712-3290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 S 2nd St",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "Bismarck",
            "state": "ND",
            "postal_code": "585045729",
            "country_code": "US",
            "telephone_number": "701-258-3780",
            "fax_number": "701-258-6431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEDERSON",
        "first_name": "MONIQUE",
        "middle_name": "ALEXANDRA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-02",
        "last_updated": "2021-02-02",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ND",
            "license": "835-6-1-15A",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ND",
            "license": "835-6-1-15-313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.vitalitymhnd.com",
            "affiliation": "N",
            "address_1": "919 S 7th St Ste 303",
            "city": "Bismarck",
            "state": "ND",
            "country_code": "US",
            "postal_code": "585045835",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Peace of Mind Counseling, PLLC
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• Roger Morris Peet, LAC
• Emma Pelach, LMSW
• Allison Evelyn Peltier, D.N.P, FNP-C

• Professional Counselor in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Professional Counselor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; 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.