Mynd Integrated LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

MYND INTEGRATED LLC

Practice address

300 NP Ave N Ste 210
Fargo, ND 58102-4871

Phone

(701) 205-1466

NPI assigned

May 20, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Erin Rachel Hagen, PH.D.NPI 1174006639

Title

Owner/Mental Health Counselor

Phone

(701) 205-1466

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Erin R Hagen, LPCC

  • Professional Counselor
  • West Fargo, ND
  • NPI 1174006639
  NPD Authorized official

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

{
    "created_epoch": "1653004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653004800000",
    "number": "1932847969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5704 3RD ST N",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565606555",
            "telephone_number": "701-220-8714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 NP AVE N STE 210",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581024871",
            "telephone_number": "701-205-1466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYND INTEGRATED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-20",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-19",
        "status": "A",
        "authorized_official_last_name": "HAGEN",
        "authorized_official_first_name": "ERIN",
        "authorized_official_middle_name": "RACHEL",
        "authorized_official_title_or_position": "OWNER/MENTAL HEALTH COUNSELOR",
        "authorized_official_telephone_number": "701-205-1466",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethany Lynn Myhre, CRNA
• Nancy O Mykleseth, LCSW
• Mickey Myles
• Myna Early Intervention LLC
• Myna Therapy Services PLLC
• Myofascial Release by Katie
• Wendy Ann Myren
• Jason C Myrmoe, MD
• Briana R Myrvik, B. S.
• N.I.a.M Brain Injury Services, LLP

• Mental Health Counselor in Fargo, ND
• Providers in Fargo, ND by specialty
• Mental Health Counselor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2022; 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.