Individual provider Active NPI

Janet Amundson, MA

  • Professional Counselor
  • Grand Forks, ND
National Provider Identifier
1932525359
Registry record updated Feb 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
866-3-1-16-279 Issued in 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
Last updated
Feb 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CC00738 MN
Professional Counselor 101YP2500X 866-3-1-16-279 ND Primary

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

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
I20240112002919 ND Practitioner - Mental Health Counselor 8426409582 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
CC00738MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Village Family Service Center Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Village Family Service Center CurrentSince Jan 1, 2024 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

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.

NPI Registry JSON

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

{
    "created_epoch": "1394409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1932525359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 25TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032311",
            "telephone_number": "701-451-4900",
            "fax_number": "651-925-0057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1726 S WASHINGTON ST STE 33A",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582016395",
            "telephone_number": "701-746-4584",
            "fax_number": "651-925-0057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMUNDSON",
        "first_name": "JANET",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-10",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC00738",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ND",
            "license": "866-3-1-16-279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

Verify at the official NPI Registry.