Individual provider Active NPI

Kassandra Jane Sofferman

  • Social Worker
  • Fargo, ND
National Provider Identifier
1699623199
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
36513 Issued in MN
Practice address
2101 Elm St N
Fargo, ND 58102-2417
Phone
(701) 239-3700
NPI assigned
Mar 19, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 36513 MN Primary

Addresses

Primary practice location

2101 Elm St N
Fargo, ND 58102-2417

Mailing address

1215 26TH Ave S
Moorhead, MN 56560-4611
Phone (218) 639-7961

Other names 1

  • Kassandra Peterson Former name

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

NPI Registry JSON

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

{
    "created_epoch": "1773878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1699623199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 26TH AVE S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565604611",
            "telephone_number": "218-639-7961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 ELM ST N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581022417",
            "telephone_number": "701-239-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOFFERMAN",
        "first_name": "KASSANDRA",
        "middle_name": "JANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-19",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "36513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KASSANDRA",
            "last_name": "PETERSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Aug 11, 2026; 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.