Individual provider Active NPI

Katrina Marie Dedona, PSYD

  • Psychologist
  • Dickinson, ND
National Provider Identifier
1770952111
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
651P Issued in ND
Practice address
1463 I94 Business Loop E
Dickinson, ND 58601-6434
Phone
(701) 227-7500
Fax
(701) 227-7575
NPI assigned
Sep 16, 2015
Last updated
Jan 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 5666 NC
Psychologist 103T00000X 651P ND Primary

Addresses

Primary practice location

1463 I94 Business Loop E
Dickinson, ND 58601-6434

Mailing address

1463 I94 Business Loop E
Dickinson, ND 58601-6434
Phone (701) 227-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20190506002831 ND Practitioner - Clinical Psychologist 1658613971 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Badlands Human Service CenterGroup PAC ID 9739085499, 18 clinicians

Practice addresses (Care Compare)

1463 I94 Business Loop E
Dickinson, ND 58601-6434
Phone (701) 227-7500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
651PNDMDPsychologist
549NDMDChiropractor
5666NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Badlands Behavioral Health Clinic CurrentSince May 1, 2019 Accepting new patients
South Central Behavioral Health Clinic CurrentSince Dec 1, 2025 Accepting new patients
Carolinas Medical Center Current Accepting new patients
Northeast Behavioral Health Clinic CurrentSince Dec 1, 2025 Accepting new patients
North Central Behavioral Health Clinic CurrentSince Dec 1, 2025 Accepting new patients
West Central Behavioral Health Clinic CurrentSince Mar 30, 2025 Accepting new patients
Lake Region Behavioral Health Clinic CurrentSince Apr 1, 2019 Accepting new patients
Northwest Behavioral Health Clinic CurrentSince Dec 1, 2025 Accepting new patients
Northeast Human Service Center CurrentSince Dec 1, 2025 Accepting new patients
Southeast Behavioral Health Clinic CurrentSince Dec 1, 2025 Accepting new patients
Carolinas Medical Center Psychologist CurrentSince Jan 6, 2020 Accepting new patients
Carolinas Medical Center CurrentSince Jan 6, 2020 Accepting new patients

Locations

251 Eastway Dr
Charlotte, NC 28213
Phone (704) 446-9991

3541 Randolph Rd
Ste 206
Charlotte, NC 28211
Phone (704) 381-8336

1237 W Divide Ave
Ste 5
Bismarck, ND 58501
Phone (701) 328-8888

600 E Boulevard Ave
Dept 325
Bismarck, ND 58505
Phone (701) 328-4644

200 Highway 2 W
Devils Lake, ND 58301
Phone (701) 665-2200

1463 I94 Business Loop E
Dickinson, ND 58601
Phone (701) 227-7500

2624 9th Ave SW
Fargo, ND 58103
Phone (701) 298-4500

151 S 4th St
Ste 401
Grand Forks, ND 58201
Phone (701) 795-3000

520 3rd St NW
Jamestown, ND 58401
Phone (701) 253-6300

1015 S Broadway
Ste 18
Minot, ND 58701
Phone (701) 857-8500

316 2nd Ave W
Williston, ND 58801
Phone (701) 774-4600

Organizations & group practices 12

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": "1442361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1770952111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1463 I94 BUSINESS LOOP E",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586016434",
            "telephone_number": "701-227-7500",
            "fax_number": "701-227-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1463 I94 BUSINESS LOOP E",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586016434",
            "telephone_number": "701-227-7500",
            "fax_number": "701-227-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEDONA",
        "first_name": "KATRINA",
        "middle_name": "MARIE",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-16",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "5666",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ND",
            "license": "651P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dickinson, ND

Sources for this page

Verify at the official NPI Registry.