Jenna Leigh Forbord

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

934-1-1-18-403 Issued in ND

Practice address

1201 25TH St S
Fargo, ND 58103-2311

Phone

(701) 451-4900

Fax

(651) 925-0057

NPI assigned

Dec 7, 2017

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Prairieland Counseling Services LLC

  • Professional Counselor
  • Fargo, ND
  • NPI 1053816298
  NPD (past)

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

{
    "created_epoch": "1512604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1669987004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 25TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032311",
            "telephone_number": "701-451-4900",
            "fax_number": "651-925-0057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 25TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032311",
            "telephone_number": "701-451-4900",
            "fax_number": "651-925-0057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORBORD",
        "first_name": "JENNA",
        "middle_name": "LEIGH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-07",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ND",
            "license": "934-1-1-18-403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cathy Denies Fonder, APRN, FNP-C
• Germaine Essangui Fongang
• Alex Fontaine, DPT
• Taylor Fontaine, PA-C
• Valerie Foran
• Forde Counseling Services PC
• June Marie Forde, LPCC
• Forest River Counseling PC
• Patrick Brian Foret
• Stacie J Forman

• Professional Counselor in Fargo, ND
• Providers in Fargo, 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 Nov 18, 2020; 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.