Janet Amundson, MA
Individual provider Active NPI Professional Counselor · Grand Forks, ND
NPI 1932525359 · NPPES record last updated Feb 17, 2020
Key facts
- NPI
- 1932525359
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 866-3-1-16-279 (ND)
- Practice address
- 1726 S Washington St Ste 33a
Grand Forks, ND 58201-6395 - Phone
- (701) 746-4584
- Fax
- (651) 925-0057
- NPI assigned
- Mar 10, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240112002919 | ND | Practitioner - Mental Health Counselor | 8426409582 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CC00738 | MN | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Village Family Service Center | Mental Health | Current |
Accepting new patients |
| Village Family Service Center | Current |
Accepting new patients |
Locations
1201 25th St SW
Fargo, ND 58103
Phone (701) 451-4855
2701 12th Ave S
Fargo, ND 58103
Phone (701) 451-4865
1726 S Washington St
Ste 33A
Grand Forks, ND 58201
Phone (701) 746-4584
4324 University Ave
Ste B
Grand Forks, ND 58203
Phone (701) 746-4584
20 1st St SW
Ste 250
Minot, ND 58701
Phone (701) 852-3328
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CC00738 | MN | |
| Professional Counselor | 101YP2500X | 866-3-1-16-279 | ND | Yes |
Addresses
Primary practice location
1726 S Washington St Ste 33a
Grand Forks, ND 58201-6395
Mailing address
1201 25TH St S
Fargo, ND 58103-2311
Phone (701) 451-4900
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41-0851371 | Other | MN | FEDRAL TAX ID |
Other providers in Grand Forks, ND
- Leah Ames
- Jade Ammons
- Lisa Amundgaard-Pagnac
- Amundson Dental Associates
- Anna Amundson
- Matthew Duane Amundson
- Roger Martin Amundson
- Scott M Amundson
- Kristi Anderson Larson
- Megan Lynn Anderson Weisgram
All providers in Grand Forks, ND · Professional Counselor in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 17, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.