Prairie St. John'S Clinic in Fargo - Clinical Child & Adolescent
Prairie St. John'S Clinic - NPI 1518059690
Prairie St. John'S Clinic is a Clinical Child & Adolescent in Fargo, North Dakota. Prairie St. John'S Clinic practices all healthcare services and medical treatments related to Clinical Child & Adolescent. The NPI Number for Prairie St. John'S Clinic is 1518059690. The last update date is 2020-08-22.
Prairie St. John'S Clinic's current location address is 510 4th St S, Fargo, North Dakota. You can contact this provider via phone number 7014767221 and fax number 7014767261. The mailing address for Prairie St. John'S Clinic is 510 4th St S, Fargo, North Dakota. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Prairie St. John'S Clinic |
|---|---|
| Address | 510 4th St S, Fargo, North Dakota |
| Phone Number | 7014767221 |
| Fax Number | 7014767261 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CHIEF FINA |
|---|---|
| Authorized Official Name | Magnison W Jerry |
| Credentials | CFO |
| Telephone Number | 7014767221 |
NPI Number Detail
| NPI Number | 1518059690 |
|---|---|
| Provider Enumeration Date | 2006-09-28 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 510 4th St S |
|---|---|
| City | Fargo |
| State | North Dakota (ND) |
| Post Code | 581031914 |
| Phone Number | 7014767221 |
| Fax Number | 7014767261 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical Child & Adolescent |
|---|---|
| Taxonomy | 103Tc2200X |
| Licence No | 5063A |
|
Definition: A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 238T5PR | MN | MINNESOTA BLUE CROSS |
Post Comment/ Review Below
What is the unique identification code assigned to Prairie St. John'S Clinic by the Centers for Medicare & Medicaid Services?
The Prairie St. John'S Clinic has been issued the NPI (National Provider Identifier) 1518059690. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Prairie St. John'S Clinic is located?
The Prairie St. John'S Clinic is situated at the following address: 510 4Th St S, Fargo, ND, 581031914.
What is the Prairie St. John'S Clinic's area of specialization and corresponding taxonomy classification?
The Prairie St. John'S Clinic's specialty field is Clinical Child & Adolescent, and it falls under the taxonomy code 103Tc2200X, which categorizes healthcare providers based on their specialties.
On what date did the Prairie St. John'S Clinic receive its 1518059690 assignment from the Centers for Medicare & Medicaid Services?
The Prairie St. John'S Clinic was assigned its 1518059690 by the Centers for Medicare & Medicaid Services on 2006-09-28.
As of what date were the Prairie St. John'S Clinic's details last updated?
The information pertaining to the Prairie St. John'S Clinic, including its address, specialty, and other details, was most recently updated on 2020-08-22.
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