Kristie Lynn Spooner, LAC, LSW

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1358 Issued in ND

Practice address

3201 Fiechtner Dr S
Fargo, ND 58103-2358

Phone

(701) 293-3384

Fax

(651) 925-0057

NPI assigned

Aug 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Soul Solutions Recovery Center Inc

  • Community/Behavioral Health Agency
  • Fargo, ND
  • NPI 1760056436
  NPD (past)
• South Central Behavioral Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jamestown, ND
  • NPI 1225075906
  NPD (past)
• South Central Human Service Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Jamestown, ND
  • NPI 1093542391
  NPD (past)
• Village Family Service Center

  • Substance Abuse Rehabilitation Facility
  • Fargo, ND
  • NPI 1952679318

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510790400000",
    "number": "1902912272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2055",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584022055",
            "telephone_number": "701-253-6366",
            "fax_number": "701-253-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 FIECHTNER DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032358",
            "telephone_number": "701-293-3384",
            "fax_number": "651-925-0057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPOONER",
        "first_name": "KRISTIE",
        "middle_name": "LYNN",
        "credential": "LAC, LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2017-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ND",
            "license": "2163",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ND",
            "license": "1358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "011580",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Spine & Soul Chiropractic PLLC
• Victoria Spofford, RN
• Shayne Marc Spokely, PT
• Erica Sponsler, RN
• Helen Dawn Spooner, RN
• Pamela Spooner
• Katelyn Sprague, OTR/L
• Mary L Sprague, FNP-C
• Casi Sprecher
• Craig R. Sprenger, M.D.

• Addiction (Substance Use Disorder) Counselor in Fargo, ND
• Providers in Fargo, ND by specialty
• Addiction (Substance Use Disorder) Counselor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2017; 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.