MR. GARY R. WENTZ (NPI# 1336339803) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336339803 |
| Entity Type | Individual |
| Full Name | MR. GARY R. WENTZ |
| Credential | L.A.C. |
| Practice Address |
311 S 4th St Ste 1 Grand Forks ND 58201-4792 |
| Practice Telephone | 7017460929 |
| Practice Fax Number | 7017460929 |
| Mailing Telephone | 7017460929 |
| Mailing Fax Number | 7017460929 |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2007-07-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
1334 | ND | Behavioral Health & Social Service Providers |
| Street Address |
311 S 4TH ST STE 1 |
| City | GRAND FORKS |
| State | ND |
| Zip Code | 58201-4792 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255965398 | Development Homes Inc | Intermediate Care Facility, Mentally Retarded | 5509 Cottonwood Street, Grand Forks, ND 58201 | 2020-02-27 |
| 1932753779 | Lydia Pansegrau | Occupational Therapist | 2950 36th Ave S, Apt A-11, Grand Forks, ND 58201 | 2019-07-30 |
| 1407416019 | Kristina Aikens | Optometrist | 1820 S 42nd St, Grand Forks, ND 58201 | 2019-06-17 |
| 1861963209 | Jessica Kovsky | Occupational Therapist | 1375 S Columbia Rd- Altru Performance Center, Grand Forks, ND 58201 | 2018-12-11 |
| 1609345834 | Altru Specialty Services, Inc | Durable Medical Equipment & Medical Supplies | 1375 South Columbia Road, Suite A, Grand Forks, ND 58201 | 2018-11-16 |
| 1225523004 | Alicia Mae Mack | Registered Nurse | 212 S. 4th St. Suite 301, Spectra Health, Grand Forks, ND 58201 | 2018-06-25 |
| 1396260808 | Amber White | Behavior Technician | 2016 S Washington St., Grand Forks, ND 58201 | 2017-08-04 |
| 1225579840 | Kathleen Suzanne Tillman | Psychologist | 2100 S Columbia Road, Suite 202, Family Institute, PC, Grand Forks, ND 58201 | 2017-03-15 |
| 1881148906 | Melissa Pytlik Monson | Physician Assistant | 1380 S Columbia Rd - Altru Family Medcine Center, Grand Forks, ND 58201 | 2016-08-05 |
| 1477936029 | Laura Jane Carlson | Nurse Practitioner | 3165 Demers Avenue - Truyu Aesthetic Center, Grand Forks, ND 58201 | 2015-07-01 |
| Find all providers in zip 58201 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477931806 | Winonah Camille Monette | Counselor | 1133 S Columbia Rd, Grand Forks, ND 58201-4050 | 2015-05-18 |
| 1790005619 | Jodi L Ramberg | Counselor | 1407 24th Ave S Ste 225, Grand Forks, ND 58201-6761 | 2010-06-02 |
| 1851572929 | Julie A I Smith | Counselor | 2100 Columbia Road South, Suite 212, Grand Forks, ND 58201 | 2007-11-17 |
| 1912063587 | Northridge Counseling Centre Inc | Counselor | 215 N 3rd Street, Suite 202a, Grand Forks, ND 58203 | 2006-12-28 |
| 1669580940 | Judith A Ewoniuk-kuzel | Counselor | 151 South 4th Street, Suite 401, Grand Forks, ND 58201-4735 | 2006-08-28 |
| 1033728357 | Shenika Nicole Bordeaux-collins | Counselor | 1451 44th Avenue South, Grand Forks, ND 58201-5820 | 2020-07-23 |
| 1295372001 | Thomas William Solem | Counselor | 2315 Library Cir, Grand Forks, ND 58201-6327 | 2019-12-01 |
| 1982266029 | George Patrick Guimont | Counselor | 151 S 4th St Ste 401, Grand Forks, ND 58201-4715 | 2019-06-28 |
| 1770148371 | Elizabeth I Meyer | Counselor | 151 S 4th St Ste 401, Grand Forks, ND 58201-4715 | 2019-05-08 |
| 1386108579 | Abby J. Samson | Counselor | 151 S 4th St Ste 401, Grand Forks, ND 58201-4715 | 2019-01-22 |
| Find all providers in GRAND FORKS | ||||
| City | GRAND FORKS |
| Zip Code | 58201 |
Please comment or provide details below to improve the information on MR. GARY R. WENTZ.
| 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.