Ismail Farah

Individual provider Active NPI Community/Behavioral Health Agency · Fargo, ND

NPI 1992692974 · NPPES record last updated Jun 21, 2025

Key facts

NPI
1992692974
Entity type
Individual (NPI type 1)
Primary specialty
Community/Behavioral Health Agency 251S00000X
License
692 (ND)
Practice address
4333 15TH Ave S Apt 324
Fargo, ND 58103-3356
Phone
(701) 541-5429
NPI assigned
Jun 21, 2025
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
692NDMDCommunity/Behavioral Health Agency

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 692 ND Yes

Addresses

Primary practice location

4333 15TH Ave S Apt 324
Fargo, ND 58103-3356

Mailing address

1301 Belsly Blvd Apt 217
Moorhead, MN 56560-5176
Phone (701) 541-5429

Other providers in Fargo, ND

All providers in Fargo, ND · Community/Behavioral Health Agency in North Dakota

Sources for this page

Verify at the official NPI Registry.