LORI JILL CHARBONNEAU (NPI# 1700074341) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700074341 |
| Entity Type | Individual |
| Full Name | LORI JILL CHARBONNEAU |
| Credential | LICSW |
| Practice Address |
1800 E Interstate Ave Ste B Bismarck ND 58503-1566 |
| Mailing Address |
Po Box 5074 Sioux Falls SD 57117-5074 |
| Practice Telephone | 7013236543 |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2020-09-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
1526 | ND | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 054517 | 05 | |
| ND | BLUE CROSS BLUE SHIELD | 024385 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1015 S Broadway, Suite 18, Minot, ND 587014667 | 7018578500 | 7018578500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932570330 | Lori Charbonneau | Nurse Practitioner | 1105 Sixth St, Traverse City, MI 49684-2349 | 2015-10-12 |
| Street Address |
1800 E INTERSTATE AVE STE B |
| City | BISMARCK |
| State | ND |
| Zip Code | 58503-1566 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174586697 | Richard E Arndorfer | Psychologist | 1800 E Interstate Ave Ste B, Bismarck, ND 58503-1566 | 2006-04-07 |
| 1861864415 | Stephanie Macdonald | Nurse Practitioner | 1800 E Interstate Ave Ste B, Bismarck, ND 58503-1566 | 2015-10-22 |
| 1710372362 | Annah Preszler | Psychiatry & Neurology | 1800 E Interstate Ave Ste B, Bismarck, ND 58503-1566 | 2015-03-31 |
| 1124467741 | Adam Jangula | Psychiatry & Neurology | 1800 E Interstate Ave Ste B, Bismarck, ND 58503-1566 | 2013-06-17 |
| 1003149790 | Nicole L Cross-hillman | Psychologist | 1800 E Interstate Ave Ste B, Bismarck, ND 58503-1566 | 2009-09-11 |
| 1417187907 | Prem Nath Pathak | Psychiatry & Neurology | 1800 E Interstate Ave Ste B, Bismarck, ND 58503-1566 | 2009-07-20 |
| 1457580110 | Sara R Bashus | Social Worker | 1800 E Interstate Ave Ste B, Bismarck, ND 58503-1566 | 2009-07-02 |
| 1689829202 | Christen G Herrick | Psychologist | 1800 E Interstate Ave Ste B, Bismarck, ND 58503-1566 | 2008-11-24 |
| 1508909540 | Michael Av Mirzai | Psychiatry & Neurology | 1800 E Interstate Ave Ste B, Bismarck, ND 58503-1566 | 2007-02-15 |
| 1053493494 | Darla J Stafford | Social Worker | 1800 E Interstate Ave Ste B, Bismarck, ND 58503-1566 | 2006-10-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356951503 | Community Options for Residential and Employment Services, Inc | Community/Behavioral Health | 4909 Shelburne St, Bismarck, ND 58503 | 2020-08-03 |
| 1104460476 | Brittany Lee Feil | Registered Nurse | 808 N Washington St., Bismarck, ND 58503 | 2019-10-30 |
| 1760030670 | Rachel Lees | Technician | 1727 Valley Drive, Bismark, ND 58503 | 2019-09-04 |
| 1700444619 | St Alexius Medical Center | Non-Pharmacy Dispensing Site | 807 East Main Suite A, Bismarck, ND 58503 | 2019-06-05 |
| 1881162972 | White Drug Co of Jamestown Inc | Pharmacy | 900 Ne 43rd Ave, Bismarck, ND 58503 | 2018-11-06 |
| 1104347137 | Adapt, Inc. | Counselor | 1720 Burnt Boat Drive, Suite 108, Bismarck, ND 58503 | 2017-06-29 |
| 1679010953 | Optimum Therapies of North Dakota, Inc | Physical Therapist | 4204 Boulder Ridge Rd, Suite 100, Bismarck, ND 58503 | 2017-01-25 |
| 1972954162 | Ava Burckhard | Speech-Language Pathologist | 4501 Coleman St N Suite #103, Pediatric Therapy Partners, Bismarck, ND 58503 | 2016-06-29 |
| 1306292842 | Margaret Williams | Nurse Practitioner | 4315 Ottawa St, Bismarck, ND 58503 | 2016-05-13 |
| 1649638958 | Horizon Chiropractic & Wellness PC | Chiropractor | 4535 Northern Sky Dr., Bismarck, ND 58503 | 2016-02-01 |
| Find all providers in zip 58503 | ||||
| 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 |
|---|---|---|---|---|
| 1649740630 | Stephanie Marie Simburger | Social Worker | 3111 East Broadway Ave, Bismarck, ND 58501 | 2018-12-03 |
| 1144728577 | Nikki Marie Mundahl | Social Worker | 315 N 11th St, Bismarck, ND 58501-4539 | 2018-01-31 |
| 1841675527 | Stephanie Rutledge | Social Worker | 7301 Keepsake Ln, Bismarck, ND 58501-8664 | 2015-07-23 |
| 1942626395 | Sanford Bismarck | Social Worker | 200 E Main Ave Ste 301, Bismarck, ND 58501-3857 | 2014-03-10 |
| 1952541294 | Rebecca Lynn Madeen | Social Worker | 1120 College Dr Ste 201, Bismarck, ND 58501-1225 | 2009-02-26 |
| 1285886838 | Tamara J. Christianson | Social Worker | 600 S 2nd St Ste 202, Bismarck, ND 58504-5729 | 2008-10-15 |
| 1306098918 | Jennifer L Roach | Social Worker | 605 Cedar St, Bismarck, MO 63624-9467 | 2008-10-14 |
| 1992919229 | Melanie L Heitkamp | Social Worker | 225 W Rosser, Bismarck, ND 58501 | 2007-05-09 |
| 1295949527 | Lowell Gary Flemmer | Social Worker | 221 W Rosser Ave, Bismarck, ND 58501 | 2007-05-09 |
| 1578784112 | Charles M Joyce | Social Worker | 418 E Broadway Ave, Suite 25, Bismarck, ND 58501-4086 | 2007-05-01 |
| Find all providers in BISMARCK | ||||
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| 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.