Individual provider Active NPI

Danielle Marie Fargo, MFT-INTERN

  • Marriage & Family Therapist
  • Reno, NV
National Provider Identifier
1912546300
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MI-1192 Issued in NV
Practice address
1325 Airmotive Way Ste 140
Reno, NV 89502-3283
Phone
(775) 737-9001
Fax
(775) 870-1628
NPI assigned
Jan 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MI-1192 NV Primary

Addresses

Primary practice location

1325 Airmotive Way Ste 140
Reno, NV 89502-3283

Mailing address

1325 Airmotive Way Ste 140
Reno, NV 89502-3283
Phone (775) 737-9001

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

LicenseStateTypeSpecialty
MI-1192NVMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Health Marriage & Family Therapist CurrentSince Jan 5, 2020 Accepting new patients
Sierra Dragonfly Center LLC Marriage & Family Therapist CurrentSince Jun 11, 2023 Accepting new patients

Locations

1325 Airmotive Way
Ste 140
Reno, NV 89502
Phone (775) 389-5433

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1577923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1912546300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 AIRMOTIVE WAY STE 140",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895023283",
            "telephone_number": "775-737-9001",
            "fax_number": "775-870-1628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 AIRMOTIVE WAY STE 140",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895023283",
            "telephone_number": "775-737-9001",
            "fax_number": "775-870-1628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARGO",
        "first_name": "DANIELLE",
        "middle_name": "MARIE",
        "credential": "MFT-INTERN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-02",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NV",
            "license": "MI-1192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2020; 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.