Individual provider Active NPI

Adam D Nygaard, LCSW

  • Social Worker
  • Grand Forks, ND
National Provider Identifier
1912214719
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
4539 Issued in ND
Practice address
860 S. Columbia Rd
Grand Forks, ND 58201
Phone
(701) 780-6697
Fax
(701) 795-3050
NPI assigned
Sep 1, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 4539 ND
Social Worker 104100000X 4539 ND Primary

Addresses

Primary practice location

860 S. Columbia Rd
Grand Forks, ND 58201

Mailing address

PO Box 13780
Grand Forks, ND 58208
Phone (701) 780-1891

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
I20240614004070 ND Practitioner - Clinical Social Worker 0345783619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of North Dakota School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stage of Change Therapy PLLCGroup PAC ID 0244753713, 2 clinicians

Practice addresses (Care Compare)

4200 James Ray Dr
Suite 305
Grand Forks, ND 58202-6090
Phone (701) 213-6999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stage of Change Therapy PLLC Clinical CurrentSince Jan 12, 2025 Accepting new patients

Locations

4200 James Ray Dr
Ste 305
Grand Forks, ND 58202
Phone (701) 213-6999

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1912214719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13780",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "58208",
            "telephone_number": "701-780-1891",
            "fax_number": "701-795-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 S. COLUMBIA RD",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "58201",
            "telephone_number": "701-780-6697",
            "fax_number": "701-795-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYGAARD",
        "first_name": "ADAM",
        "middle_name": "D",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-01",
        "last_updated": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "4539",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ND",
            "license": "4539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

Verify at the official NPI Registry.