Individual provider Active NPI

Kenneth Allen Hodem, LPCC

  • Professional Counselor
  • Grand Forks, ND
National Provider Identifier
1770173817
Registry record updated Jan 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1109-2-15-21-556 Issued in ND
Practice address
3674 S Washington St
Grand Forks, ND 58201-5766
Phone
(701) 205-3000
Fax
(701) 732-2501
NPI assigned
Jan 22, 2021
Last updated
Jan 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1109-2-15-21-556 ND Primary

Addresses

Primary practice location

3674 S Washington St
Grand Forks, ND 58201-5766

Mailing address

PO Box 5210
Grand Forks, ND 58206-5210
Phone (701) 205-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, MN, MT, AK4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20240130003416 ND Practitioner - Mental Health Counselor 1850744418 Reassigns benefits to 1 organization
I20240515000314 MN Practitioner - Mental Health Counselor 1850744418 Reassigns benefits to 1 organization
I20240604000987 MT Practitioner - Mental Health Counselor 1850744418 Reassigns benefits to 1 organization
I20250507002489 AK Practitioner - Mental Health Counselor 1850744418 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Peterson Medical Clinics LLCGroup PAC ID 9335412220, 91 clinicians

Practice addresses (Care Compare)

125 Airport Rd
Chinook, MT 59523-7830
Phone (701) 205-3000

3674 S Washington St
Grand Forks, ND 58201-5766

4501 15TH Ave SW
Suite 105
Fargo, ND 58103-8956
Phone (701) 205-3000

519 Anne St NW
Suite a
Bemidji, MN 56601-4277
Phone (701) 205-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4396MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Norton Sound Health Corporation CurrentSince Apr 18, 2025 Accepting new patients
Norton Sound Health Corporation Current Accepting new patients
Norton Sound Health Corporation CurrentSince Apr 18, 2025 Accepting new patients
Sweet Memorial Nursing Home CurrentSince Apr 9, 2024 Accepting new patients
Peterson Medical Clinics, LLC CurrentSince Jan 1, 2024 Accepting new patients
Lake Country Associates, Inc. PastSince Mar 15, 2010 Accepting new patients
Southwestern Dist Health Unit Past Accepting new patients

Locations

205 E Benson Blvd
Ste 401
Anchorage, AK 99503

123 3rd Ave E
Ste 300
Alexandria, MN 56308

700 Cedar St
Ste 228
Alexandria, MN 56308
Phone (320) 762-3935

519 Anne St NW
Ste A
Bemidji, MN 56601
Phone (218) 444-5700

1010 S Birch Ave
Hallock, MN 56728
Phone (218) 843-3612

205 Roosevelt Ave W
Karlstad, MN 56732
Phone (218) 436-2251

515 Bridge St
Park Rapids, MN 56470
Phone (218) 252-0066

960 S 24th St W
Ste H
Billings, MT 59102
Phone (406) 272-2376

721 Central Ave
Ste 107
Great Falls, MT 59401

424 S 3rd St
Ste 1
Bismarck, ND 58504

528 21st St W
Dickinson, ND 58601
Phone (701) 483-0171

4501 15th Ave SW
Ste 105
Fargo, ND 58103

3674 S Washington St
Grand Forks, ND 58201
Phone (701) 732-2538

4700 S Washington St
Ste G
Grand Forks, ND 58201
Phone (701) 732-2506

1408 20th Ave SW
Ste 5
Minot, ND 58701

Organizations & group practices 7

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": "1611273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769040000000",
    "number": "1770173817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5210",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582065210",
            "telephone_number": "701-205-3000",
            "fax_number": "701-732-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3674 S WASHINGTON ST",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582015766",
            "telephone_number": "701-205-3000",
            "fax_number": "701-732-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODEM",
        "first_name": "KENNETH",
        "middle_name": "ALLEN",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-22",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ND",
            "license": "1109-2-15-21-556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

Verify at the official NPI Registry.