SPIRIT LAKE TRIBE (NPI# 1144771650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144771650 |
| Entity Type | Organization |
| Organization Name | SPIRIT LAKE TRIBE |
| Other Organization Name | SPIRIT LAKE HEALTH CENTER |
| Practice Address |
3883 74th Ave Ne Fort Totten ND 58335 |
| Mailing Address |
Po Box 309 Fort Totten ND 58335-0309 |
| Practice Telephone | 7017661600 |
| Practice Fax Number | 7017661630 |
| Mailing Telephone | 7017661600 |
| Mailing Fax Number | 7017661630 |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2016-10-19 |
| Authorized Official Name | MICHELLE BELT (CEO) |
| Authorized Official Telephone | 7017661600 |
| Is Organization Subpart | Y |
| Parent Organization Name | SPIRIT LAKE TRIBE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Spirit Lake Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053515783 | Spirit Lake Tribe | Ambulance | 1403 Brunswick Ave, Fort Totten, ND 58335-0449 | 2007-06-14 |
| 1720152457 | Spirit Lake Tribe | Case Management | 416 2nd Avenue North, Fort Totten, ND 58335 | 2006-11-17 |
| 1740387059 | Spirit Lake Tribe | Ambulance | 7686 Ephriam Hill Road, Fort Totten, ND 58335 | 2006-09-20 |
| 1821622010 | Spirit Lake Tribe | Non-emergency Medical Transport (VAN) | 3883 74th Ave Ne, Fort Totten, ND 58335-0309 | 2020-02-26 |
| 1225576341 | Spirit Lake Tribe | Internal Medicine | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2017-02-09 |
| 1417408907 | Spirit Lake Tribe | Optometrist | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2016-10-19 |
| 1609327196 | Spirit Lake Tribe | Psychiatry & Neurology | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2016-10-19 |
| 1508317090 | Spirit Lake Tribe | Dentist | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2016-10-19 |
| 1912458407 | Spirit Lake Tribe | Radiology | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2016-10-19 |
| 1063963551 | Spirit Lake Tribe | Physician Assistant | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2016-10-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SPIRIT LAKE TRIBE | 816 3 Ave N, Fort Totten, ND 58335-9998 |
| Street Address |
3883 74TH AVE NE |
| City | FORT TOTTEN |
| State | ND |
| Zip Code | 58335 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124646146 | Liza A Ystaas | Nurse Practitioner | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2020-07-07 |
| 1205453172 | Mikkel Elizabeth Buckmier | Nurse Practitioner | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2020-06-26 |
| 1821622010 | Spirit Lake Tribe | Non-emergency Medical Transport (VAN) | 3883 74th Ave Ne, Fort Totten, ND 58335-0309 | 2020-02-26 |
| 1144874108 | Sarah Ruth Cavanaugh | Dentist | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2019-07-29 |
| 1629508452 | Jacqueline Patrice Schroeder | Registered Nurse | 3883 74th Ave Ne, Fort Totten, ND 58335-5833 | 2017-06-14 |
| 1831629732 | Ashley Storbakken | Registered Nurse | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2017-06-14 |
| 1740710649 | Kyla Sarah Delorme | Registered Nurse | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2017-06-14 |
| 1386174316 | Chelsea Rose Young | Licensed Practical Nurse | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2017-06-13 |
| 1518496207 | Angela I Cross | Licensed Practical Nurse | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2017-06-07 |
| 1225576341 | Spirit Lake Tribe | Internal Medicine | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2017-02-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356941116 | Sherry Yvonne Longie | Technician | 213 Dakotah Dr. #53, Fort Totten, ND 58335 | 2020-10-29 |
| 1235650250 | Tiffaney Anne Two Eagle | Registered Nurse | 3883 74th Avenue Northeast, Fort Totten, ND 58335 | 2017-06-29 |
| 1093015265 | Spirit Lake Head Start | Clinic/Center | 816 3rd Ave North, Fort Totten, ND 58335 | 2010-10-22 |
| 1154532000 | Nancy C Dauphinais | Technician, Pathology | 3883 74th Avenue North East, Fort Totten, ND 58335 | 2007-05-24 |
| 1467575159 | Jeanette Lucille Rosenheim | Registered Nurse | Spirit Lake Health Center, 3883 74th Ave Ne Box 309, Fort Totten, ND 58335 | 2007-04-09 |
| 1184744518 | Tammy Delaine Lawrence | Registered Nurse | 3883 74th Avenue Ne, Fort Totten, ND 58335 | 2007-03-30 |
| 1821127036 | Evangeline S. Gaid | Family Medicine | 3883 74th Ave.ne, Ft. Totten, ND 58335 | 2007-03-05 |
| 1538296199 | Cheri J Schaffer | Registered Nurse | 3883 74th Ave North East, Fort Totten, ND 58335 | 2007-02-28 |
| 1720152457 | Spirit Lake Tribe | Case Management | 416 2nd Avenue North, Fort Totten, ND 58335 | 2006-11-17 |
| 1740387059 | Spirit Lake Tribe | Ambulance | 7686 Ephriam Hill Road, Fort Totten, ND 58335 | 2006-09-20 |
| Find all providers in zip 58335 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962833129 | Joni Rae Henry | Social Worker | 3883 74th Ave, Ne, Fort Totten, ND 58335-0309 | 2013-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619518412 | Empowered Therapy By Tara Lorenz, Pllc | Social Worker | 722 N Main St Unit 4b, Watford City, ND 58854-7351 | 2019-10-02 |
| 1992353387 | Drew Jaeger | Social Worker | 1726 S Washington St Ste 60, Grand Forks, ND 58201-6370 | 2019-08-28 |
| 1093362428 | Sisson Counseling Services LLC | Social Worker | 300 2nd Ave Ne Ste 203, Jamestown, ND 58401-3373 | 2019-08-21 |
| 1265091235 | Katie Shannon Licsw-llc | Social Worker | 1500 14th St W Ste 230, Williston, ND 58801-4078 | 2019-06-12 |
| 1861955296 | Empower Counseling LLC | Social Worker | 4675 40th Ave S Ste 130, Fargo, ND 58104-4444 | 2019-04-11 |
| 1649740630 | Stephanie Marie Simburger | Social Worker | 3111 East Broadway Ave, Bismarck, ND 58501 | 2018-12-03 |
| 1780150086 | Heather Lynn Ives | Social Worker | 408 1st Ave Ne, Mohall, ND 58761-4318 | 2018-10-15 |
| 1992287957 | Jamie Lynn Sehrt | Social Worker | 860 S Columbia Rd Bldg 1, Grand Forks, ND 58201-4028 | 2018-09-05 |
| 1780165415 | Kaleidoscope Behavioral Health | Social Worker | 511 2nd St W Ste B, Williston, ND 58801-5907 | 2018-08-21 |
| 1144728577 | Nikki Marie Mundahl | Social Worker | 315 N 11th St, Bismarck, ND 58501-4539 | 2018-01-31 |
| Find all providers with the same taxonomy | ||||
| City | FORT TOTTEN |
| Zip Code | 58335 |
Please comment or provide details below to improve the information on SPIRIT LAKE TRIBE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.