Roberta J Pytlik, LAC, LPCC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1659 Issued in ND

Practice address

17 7TH St S
Fargo, ND 58103-1800

Phone

(701) 478-1221

NPI assigned

Sep 20, 2011

Last updated

Nov 1, 2019By the provider in NPPES

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)

Not enrolled

Practice roles

Locations

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.

• Forest River Counseling PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fargo, ND
  • NPI 1043900731
  NPD Authorized official

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

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1760765416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6211 57TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581045720",
            "telephone_number": "701-793-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 7TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031800",
            "telephone_number": "701-478-1221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2624 9th Ave S",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581032350",
            "country_code": "US",
            "telephone_number": "701-298-4500 x4711",
            "fax_number": "701-298-4400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 4th St S Ste 112",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581031929",
            "country_code": "US",
            "telephone_number": "701-793-5400",
            "fax_number": "701-478-1222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PYTLIK",
        "first_name": "ROBERTA",
        "middle_name": "J",
        "credential": "LAC, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-20",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ND",
            "license": "1659",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ND",
            "license": "873-4-15-16-365",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pure Chiropractic & Rehab PC
• Purpose Counseling PC
• Puzzle Piece Speech
• Jennifer Renee Heldt Pyper, LICSW
• Melissa M Pytlik Monson, PA-C
• Ahmer H Qarni, MD
• Kandia Qual
• Afton Quale
• Marsha Quale, CCC-SLP
• Mary J Qualey, RPH

• Addiction (Substance Use Disorder) Counselor in Fargo, ND
• Providers in Fargo, ND by specialty
• Addiction (Substance Use Disorder) Counselor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2019; 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.