Individual provider Active NPI

Thomas Kenneth Dubbels, M.S., LPC

  • Mental Health Counselor
  • Fargo, ND
National Provider Identifier
1740172550
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
819-1-15-15 Issued in ND
Practice address
4357 13TH Ave S Ste 104
Fargo, ND 58103-7504
Phone
(701) 306-8369
Fax
(701) 450-0457
NPI assigned
Jul 16, 2025
Last updated
Jul 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 819-1-15-15 ND Primary

Addresses

Primary practice location

4357 13TH Ave S Ste 104
Fargo, ND 58103-7504

Mailing address

1051 50TH Ave W
West Fargo, ND 58078-7213
Phone (701) 388-6194

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
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Empowered Life Counseling, PLLC Mental Health CurrentSince Jul 22, 2025 Accepting new patients

Locations

4357 13th Ave S
Ste 104
Fargo, ND 58103
Phone (701) 306-8369

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": "1752624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1740172550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 50TH AVE W",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580787213",
            "telephone_number": "701-388-6194",
            "fax_number": "701-450-0457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4357 13TH AVE S STE 104",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581037504",
            "telephone_number": "701-306-8369",
            "fax_number": "701-450-0457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBBELS",
        "first_name": "THOMAS",
        "middle_name": "KENNETH",
        "name_prefix": "Mr.",
        "credential": "M.S., LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-07-16",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ND",
            "license": "819-1-15-15",
            "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 Jul 16, 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.