Active NPI
Groslie Counseling Services PC
- Multi-Specialty Clinic/Center
- Fargo, ND
National Provider Identifier
1639767791
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Multi-Specialty Clinic/Center
- Legal business name
- GROSLIE COUNSELING SERVICES PC
- Practice address
- 4160 24 Ave S
Ste 102
Fargo, ND 58104-9038 - Phone
- (701) 941-0175
- Fax
- (701) 941-3001
- NPI assigned
- Jan 5, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dawn Groslie, LPCC
- Title
- Owner
- Phone
- (701) 941-0175
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | Primary | ||
| Medical Specialty Clinic/Center | 261QM2500X |
Addresses
Primary practice location
4160 24 Ave S
Ste 102
Fargo, ND 58104-9038
Mailing address
4160 24 Ave S
Ste 102
Fargo, ND 58104-9038
Phone (701) 941-0175
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1470330 | Medicaid | ND |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609804800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1711670400000",
"number": "1639767791",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4160 24 AVE S",
"address_2": "STE 102",
"city": "FARGO",
"state": "ND",
"postal_code": "581049038",
"telephone_number": "701-941-0175",
"fax_number": "701-941-3001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4160 24 AVE S",
"address_2": "STE 102",
"city": "FARGO",
"state": "ND",
"postal_code": "581049038",
"telephone_number": "701-941-0175",
"fax_number": "701-941-3001"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GROSLIE COUNSELING SERVICES PC",
"organizational_subpart": "NO",
"enumeration_date": "2021-01-05",
"last_updated": "2024-03-29",
"certification_date": "2021-08-03",
"status": "A",
"authorized_official_last_name": "GROSLIE",
"authorized_official_first_name": "DAWN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "701-941-0175",
"authorized_official_credential": "LPCC"
},
"taxonomies": [
{
"code": "261QM1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Multi-Specialty",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QM2500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Medical Specialty",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1470330",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}
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 Mar 29, 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.