Tyrone L Crew

Primary specialty

Religious Nonmedical PractitionerTaxonomy code 374K00000X

Legal business name

TYRONE L CREW

Doing business as

Mediation Of The Self

Practice address

4330 10TH Ave S Apt 305
Fargo, ND 58103-7088

Phone

(701) 730-9365

NPI assigned

Dec 5, 2019

Organization subpart

No

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

Authorized official

Name

Tyrone Crew

Title

Owner

Phone

(701) 730-9365

Specialties & licenses 1

Addresses

Other names 1

• Mediation Of The Self Doing business as

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

{
    "created_epoch": "1575504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707004800000",
    "number": "1629615000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4330 10TH AVE S APT 305",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581037088",
            "telephone_number": "701-730-9365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 10TH AVE S APT 305",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581037088",
            "telephone_number": "701-730-9365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYRONE L CREW",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-05",
        "last_updated": "2024-02-04",
        "certification_date": "2024-02-04",
        "status": "A",
        "authorized_official_last_name": "CREW",
        "authorized_official_first_name": "TYRONE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-730-9365"
    },
    "taxonomies": [
        {
            "code": "374K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Religious Nonmedical Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mediation Of The Self",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Marie Twedell
• Dale Twedt, LICSW, LMFT
• Jessica Ann Tweten, OTR/L
• Kerri L Tweten, MNT
• Brittany Nicole Twiss, RD, LRD
• Alissa Kristine Tyryfter
• Ashley Ann Ueckert, DC
• Nicole Ueckert, RN
• Thomas Ugelstad, PMHNP-BC
• Marvin Lewis Ugland, DDS

• Religious Nonmedical Practitioner in Fargo, ND
• Providers in Fargo, ND by specialty
• Religious Nonmedical Practitioner in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.