Active NPI
Sara Simenson
- Professional Counselor
- Moorhead, MN
National Provider Identifier
1831869007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 3023
- Practice address
- 4000 28TH Ave S
Moorhead, MN 56560-7926 - Phone
- (701) 234-3200
- Fax
- (701) 234-3239
- NPI assigned
- Sep 17, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | |||
| Professional Counselor | 101YP2500X | 3023 | MN | Primary |
Addresses
Primary practice location
4000 28TH Ave S
Moorhead, MN 56560-7926
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-9419
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3023 | MN | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724716800000",
"number": "1831869007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5074",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571175074",
"telephone_number": "605-328-9419",
"fax_number": "218-287-5928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4000 28TH AVE S",
"city": "MOORHEAD",
"state": "MN",
"postal_code": "565607926",
"telephone_number": "701-234-3200",
"fax_number": "701-234-3239"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMENSON",
"first_name": "SARA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-17",
"last_updated": "2024-08-27",
"certification_date": "2024-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MN",
"license": "3023",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moorhead, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.