Individual provider Active NPI

Roberta J Stinson, MAC, LMAC, LADC, LAT

  • Addiction (Substance Use Disorder) Counselor
  • Fargo, ND
National Provider Identifier
1740452093
Registry record updated Sep 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1517 Issued in ND
Practice address
4227 9TH Ave S
Fargo, ND 58103-2018
Phone
(701) 282-6561
Fax
(651) 925-0046
NPI assigned
Mar 27, 2008
Last updated
Sep 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LAT-359 WY
Addiction (Substance Use Disorder) Counselor 101YA0400X 302304 MN
Addiction (Substance Use Disorder) Counselor 101YA0400X 1517 ND Primary

Addresses

Primary practice location

4227 9TH Ave S
Fargo, ND 58103-2018

Mailing address

4227 9TH Ave SW
Fargo, ND 58103-2018
Phone (701) 282-6564

Other practice location 1

505 40th St S Unit B
Fargo, ND 58103-1184
Phone (701) 282-6561

Other names 1

  • Roberta Griffin-Stinson Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address askacounselor@sharehouse.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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

Enrollment IDStateProvider typePAC IDDetails
I20240111003225 WY Practitioner - Mental Health Counselor 2567813702 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
302304MNMDAddiction (Substance Use Disorder) Counselor
LAT-359WYMDAddiction (Substance Use Disorder) Counselor
1517NDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
High Country Behavioral Health Current Accepting new patients
High Country Behavioral Health CurrentSince Dec 12, 2023 Accepting new patients
High Country Behavioral Health CurrentSince Dec 12, 2023 Accepting new patients
High Country Behavioral Health Past Accepting new patients
High Country Behavioral Health Past Accepting new patients
High Country Behavioral Health Past Accepting new patients
High Country Behavioral Health Past Accepting new patients
High Country Behavioral Health Past Accepting new patients
Sharehouse Genesis PastSince Sep 27, 2020 Accepting new patients
High Country Behavioral Health Past Accepting new patients
High Country Behavioral Health Past Accepting new patients
High Country Behavioral Health Past Accepting new patients
High Country Behavioral Health Past Accepting new patients

Locations

1841 Madora Ave
Douglas, WY 82633

190 Overthrust Rd
Evanston, WY 82930
Phone (307) 389-5764

821 Sage Ave
Kemmerer, WY 83101
Phone (307) 877-4466

721 W Maple St
Rawlins, WY 82301
Phone (307) 324-7156

121 S 4th St
Thermopolis, WY 82443
Phone (307) 864-3138

Interoperability endpoints

  • Direct secure messaging: askacounselor@sharehouse.org

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1206576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1740452093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4227 9TH AVE SW",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032018",
            "telephone_number": "701-282-6564",
            "fax_number": "701-277-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4227 9TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032018",
            "telephone_number": "701-282-6561",
            "fax_number": "651-925-0046"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 40th St S Unit B",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581031184",
            "country_code": "US",
            "telephone_number": "701-282-6561",
            "fax_number": "651-925-0046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STINSON",
        "first_name": "ROBERTA",
        "middle_name": "J",
        "credential": "MAC, LMAC, LADC, LAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-27",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WY",
            "license": "LAT-359",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "302304",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ND",
            "license": "1517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "askacounselor@sharehouse.org",
            "affiliation": "N",
            "endpointDescription": "Ask a counselor email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "4227 9th Ave S",
            "city": "Fargo",
            "state": "ND",
            "country_code": "US",
            "postal_code": "581032018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ROBERTA",
            "last_name": "GRIFFIN-STINSON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.