Kaleidoscope Behavioral Health

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4168 Issued in ND

Legal business name

KALEIDOSCOPE BEHAVIORAL HEALTH

Practice address

511 2ND St W Ste B
Williston, ND 58801-5907

Phone

(701) 580-0846

NPI assigned

Aug 21, 2018

Organization subpart

No

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

Authorized official

Name

Sarah Anderson, LICSW

Title

Therapist

Phone

(701) 580-0846

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534809600000",
    "number": "1780165415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 2ND ST W STE B",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588015907",
            "telephone_number": "701-580-0846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 2ND ST W STE B",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588015907",
            "telephone_number": "701-580-0846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KALEIDOSCOPE BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-21",
        "last_updated": "2018-08-21",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "701-580-0846",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "4168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1453283",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenna Johnston, M.S. SLP
• Krista L Jones
• Joseph E Adducci, PC
• Jennifer Jurak
• Fareed Zakeer Kadum, MD
• Heidi Kalina
• Sara E. Kasmer, LSW
• Katie Shannon Licsw LLC
• Nathan Keeler, PHARMD
• Roxanne R Keene, MD

• All providers in Williston, ND
• Clinical Social Worker in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2018; 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.