Individual provider Active NPI

Katelyn Rae St Peter, LCSW

  • Clinical Social Worker
  • Fargo, ND
National Provider Identifier
1861242752
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6712 Issued in ND
Practice address
1112 Nodak Dr S
Fargo, ND 58103-2333
Phone
(701) 232-6224
Fax
(701) 232-4687
NPI assigned
Mar 25, 2024
Last updated
Aug 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6712 ND Primary

Addresses

Primary practice location

1112 Nodak Dr S
Fargo, ND 58103-2333

Mailing address

1112 Nodak Dr S
Fargo, ND 58103-2333
Phone (701) 232-6224

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
I20260526001146 ND Practitioner - Clinical Social Worker 4183194731 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians

Practice addresses (Care Compare)

1220 Sheyenne St
West Fargo, ND 58078-2637
Phone (701) 234-4445

7951 Jacks Way
Horace, ND 58047-9002
Phone (701) 234-8830

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33050MNMDSocial Worker
6712NDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Christian Counseling Center Inc Social Worker CurrentSince Aug 13, 2026 Accepting new patients

Locations

1112 Nodak Dr S
Fargo, ND 58103
Phone (701) 232-6224

Organizations & group practices 2

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1861242752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 NODAK DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032333",
            "telephone_number": "701-232-6224",
            "fax_number": "701-232-4687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 NODAK DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032333",
            "telephone_number": "701-232-6224",
            "fax_number": "701-232-4687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST PETER",
        "first_name": "KATELYN",
        "middle_name": "RAE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-25",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "6712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.