Individual provider Active NPI

Derek Wallenstein

  • Social Worker
  • Fargo, ND
National Provider Identifier
1689271371
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
1635 43Rd St S Ste 105
Fargo, ND 58103-3579
Phone
(701) 412-2973
NPI assigned
Oct 6, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X
Social Worker 104100000X Primary

Addresses

Primary practice location

1635 43Rd St S Ste 105
Fargo, ND 58103-3579

Mailing address

1547 30TH Ave S
Moorhead, MN 56560-5149
Phone (218) 287-4338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Solutions Behavioral Healthcare Professionals, PC CurrentSince Sep 14, 2025 Accepting new patients

Locations

891 Belsly Blvd
Moorhead, MN 56560
Phone (701) 412-2973

1547 30th Ave S
Moorhead, MN 56560
Phone 21828743381113

1126 Westrac Dr S
Fargo, ND 58103
Phone (701) 412-2973

1635 43rd St S
Ste 105
Fargo, ND 58103
Phone (701) 412-2973

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1601942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1689271371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1547 30TH AVE S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565605149",
            "telephone_number": "218-287-4338",
            "fax_number": "218-287-5928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 43RD ST S STE 105",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033579",
            "telephone_number": "701-412-2973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLENSTEIN",
        "first_name": "DEREK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-06",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 11, 2025; 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.