DR. MERYL G WILLERT (NPI# 1346210499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346210499 |
| Entity Type | Individual |
| Full Name | DR. MERYL G WILLERT |
| Credential | PHD |
| Practice Address |
300 45th St Sw Suite 311 Fargo ND 58103-1189 |
| Mailing Address |
Po Box 1148 Minot ND 58702-1148 |
| Practice Telephone | 7018376508 |
| Practice Fax Number | 7018581839 |
| Mailing Telephone | 7018376508 |
| Mailing Fax Number | 7018581839 |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2007-08-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
287 | ND | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | TRICARE | 20281773958103A002 | 01 |
| ND | BCBS - BISMARCK | 58569 | 01 |
| ND | 18694 | 05 | |
| MEDICA (UBH) | 61-28263 | 01 | |
| ND | BCBS - FARGO | 28565 | 01 |
| BCBS - MINOT | 28552 | 01 |
| Street Address |
300 45TH ST SW SUITE 311 |
| City | FARGO |
| State | ND |
| Zip Code | 58103-1189 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902940182 | Dakota Family Services, Inc | Counselor | 300 45th St Sw, Suite 311, Fargo, ND 58103-1189 | 2007-02-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659924843 | Amanda Hericks | Dentist | 1338 Gateway Drive S, Fargo, ND 58103 | 2019-07-17 |
| 1285298240 | Ann Louise Breen | Optometrist | Sanford Southpointe Eye Center & Optical, 2400 32nd Ave. S., Fargo, ND 58103 | 2019-04-25 |
| 1245706597 | Lisa Elaine Livingston | Counselor | 1337 14 and Half St. S., Fargo, ND 58103 | 2018-10-15 |
| 1528569662 | Misty Lynn Hagen | Counselor | 901 28th St. South, Suite B, Fargo, ND 58103 | 2018-02-23 |
| 1083133011 | Faith Homecare Professionals LLC | Home Health | 304 25th St S, Suite B, Fargo, ND 58103 | 2017-09-11 |
| 1982138749 | Matthew Troyer | Pharmacist | 2425 13th Ave, Fargo, ND 58103 | 2017-04-18 |
| 1801338504 | Amy Nguyen Christianson | Chiropractor | 1650 45th St S Ste 113, Fargo, ND 58103 | 2016-11-11 |
| 1245772359 | Andrea Marie Hanson | Nurse Practitioner | 2400 32nd Ave South, Fargo, ND 58103 | 2016-11-07 |
| 1831647940 | Abigail Carmen Burkett Vetter | Nurse Practitioner | 2928 University Dr S Suite 101, Fargo, ND 58103 | 2016-09-18 |
| 1013361302 | Nancy Knowlton | Speech-Language Pathologist | 3001 11th Ave S, Beyond Boundaries Speech-language, Fargo, ND 58103 | 2016-04-22 |
| Find all providers in zip 58103 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013542182 | Nicola Ashton Herting | Psychologist | 100 4th St S Ste 302, Fargo, ND 58103-1937 | 2020-03-09 |
| 1669743977 | Scott Ressler | Psychologist | 3678 Taylor St S, Fargo, ND 58104-7588 | 2012-01-18 |
| 1679873525 | Jessica Ann Hurdelbrink Jones | Psychologist | 1126 Westrac Dr S, Fargo, ND 58103-2473 | 2010-10-26 |
| 1467555078 | Jenny Kathryn Frissell | Psychologist | 510 4 St S, Fargo, ND 58103 | 2006-09-07 |
| 1699878256 | Kevin Makay Schumacher | Psychologist | 3120 25th St S Ste Z, #340, Fargo, ND 58103-6164 | 2006-09-07 |
| 1821019043 | Scott V Sternhagen | Psychologist | 112 University Dr N, Suite 200, Fargo, ND 58102-4661 | 2006-07-22 |
| 1821068966 | Wayne D Samuelson | Psychologist | 1351 Page Dr S Ste 105, Fargo, ND 58103-3536 | 2006-01-23 |
| 1750923033 | Samantha J. Tupy | Psychologist | 2101 Elm St N, Fargo, ND 58102-2417 | 2019-10-08 |
| 1982168589 | Kathryn Gordon | Psychologist | 2400 32nd Ave S, Fargo, ND 58103-5800 | 2019-01-28 |
| 1801399456 | Courtney Grace Stufflebeam | Psychologist | 2101 Elm St N, Fargo, ND 58102-2417 | 2018-03-09 |
| Find all providers in FARGO | ||||
Please comment or provide details below to improve the information on DR. MERYL G WILLERT.
| 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.