Active NPI
Tiahna Edevold
- Social Worker
- Grand Forks, ND
National Provider Identifier
1962363069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6123
- Practice address
- 2400 47TH Ave S
Grand Forks, ND 58201-3405 - Phone
- (701) 746-2400
- NPI assigned
- Nov 19, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6123 | ND | MD | Social Worker |
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6123 | ND | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
2400 47TH Ave S
Grand Forks, ND 58201-3405
Mailing address
2400 47TH Ave S
Grand Forks, ND 58201-3405
Phone (701) 746-2400
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 19, 2025.
{
"created_epoch": "1763510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763510400000",
"number": "1962363069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 47TH AVE S",
"city": "GRAND FORKS",
"state": "ND",
"postal_code": "582013405",
"telephone_number": "701-746-2400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 47TH AVE S",
"city": "GRAND FORKS",
"state": "ND",
"postal_code": "582013405",
"telephone_number": "701-746-2400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDEVOLD",
"first_name": "TIAHNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-11-19",
"last_updated": "2025-11-19",
"certification_date": "2025-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ND",
"license": "6123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Forks, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.