Amy Runcorn, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

977-9-15-18 Issued in ND

Practice address

4357 13TH Ave S Ste 211
Fargo, ND 58103-7506

Phone

(701) 248-5300

NPI assigned

Nov 3, 2021

Last updated

Mar 7, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Prairieland Counseling Services LLC

  • Professional Counselor
  • Fargo, ND
  • NPI 1053816298
  NPD

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

{
    "created_epoch": "1635897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1629733878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4357 13TH AVE S STE 211",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581037506",
            "telephone_number": "701-248-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4357 13TH AVE S STE 211",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581037506",
            "telephone_number": "701-248-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNCORN",
        "first_name": "AMY",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-03",
        "last_updated": "2022-03-07",
        "certification_date": "2022-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ND",
            "license": "977-9-15-18",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Tveit Rugg, PT
• Raul Ruiz Esponda, M.D
• Katie M Rummel, OTR
• Kendrick Rummel, PHARM.D.
• Douglas L Rumpza, LAC
• Ariel Marie Running Bear, RN
• Courtney Runningen, PHARMD
• Cydney Judith Runsvold, RPH
• Mark A Runyan, DDS
• Ashley Marie Rupp

• Mental Health Counselor in Fargo, ND
• Providers in Fargo, ND by specialty
• Mental Health Counselor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; 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.