Lori C Mohagen, LAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1717 Issued in ND

Practice address

2424 32ND Ave S Ste 202
Grand Forks, ND 58201-6545

Phone

(701) 746-6336

Fax

(701) 772-1030

NPI assigned

Aug 22, 2008

Last updated

Jan 24, 2017By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Amber Waves Therapy PLLCGroup PAC ID 9335515980, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Amber Waves Therapy PLLC

  • Clinical Social Worker
  • Grand Forks, ND
  • NPI 1962127555
  Medicare reassignment Care Compare group NPD
• Agassiz Associates, PLLC

  • Clinical Psychologist
  • Grand Forks, ND
  • NPI 1700972122
  NPD (past)

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

{
    "created_epoch": "1219363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485216000000",
    "number": "1659528537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 32ND AVE S STE 202",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582016545",
            "telephone_number": "701-746-6336",
            "fax_number": "701-772-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 32ND AVE S STE 202",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582016545",
            "telephone_number": "701-746-6336",
            "fax_number": "701-772-1030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAGEN",
        "first_name": "LORI",
        "middle_name": "C",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-22",
        "last_updated": "2017-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ND",
            "license": "1717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon James Moeller, DPT
• Heather Moen, LAC
• Shyanne Moen
• Stacie J Moen, FNP
• Michaela Moffett
• Peggy M Mohr, PT
• Thomas Michael Mohr, P.T.
• Tiana Rose Moilanen, LCSW
• Omaka Mokambe, RN, BSN
• Apryl J Molstad, MOTR/L

• Addiction (Substance Use Disorder) Counselor in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Addiction (Substance Use Disorder) Counselor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.