STEPHEN A WONDERLICH (NPI# 1962423202) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962423202 |
| Entity Type | Individual |
| Full Name | STEPHEN A WONDERLICH |
| Credential | PHD |
| Practice Address |
100 4th St S Fargo ND 58103-1929 |
| Practice Telephone | 7012344111 |
| Practice Fax Number | 7012344130 |
| Mailing Telephone | 7012344111 |
| Mailing Fax Number | 7012344130 |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2008-11-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TP0814X |
Psychologist Specialization: Psychoanalysis |
187 | ND | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 16965 | 05 | |
| MN | 014550500 | 05 |
| Street Address |
100 4TH ST S |
| City | FARGO |
| State | ND |
| Zip Code | 58103-1929 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720078405 | Mark Allan Schaffer | Dentist | 100 4th St S, Suite 312, Fargo, ND 58103-1929 | 2005-10-25 |
| 1386280261 | Canopy Medical Clinic, Pllc | Nurse Practitioner | 100 4th St S, Fargo, ND 58103-1929 | 2019-11-26 |
| 1437715166 | Diana Rose Slivensky | Psychologist | 100 4th St S, Fargo, ND 58103-1929 | 2019-05-17 |
| 1861945784 | Resolve Behavioral Health, LLC | Community/Behavioral Health | 100 4th St S, Fargo, ND 58103-1929 | 2016-07-27 |
| 1578927315 | Jason Cossette | Pharmacist | 100 4th St S, Fargo, ND 58103-1929 | 2016-04-07 |
| 1437521366 | Nicole A Kiewel | Clinical Neuropsychologist | 100 4th St S, Fargo, ND 58103-1929 | 2015-10-30 |
| 1821472143 | Angela M Lee | Nurse Practitioner | 100 4th St S, Fargo, ND 58103-1929 | 2015-07-16 |
| 1104231992 | Mustafa Abdulhusein | Psychiatry & Neurology | 100 4th St S, Fargo, ND 58103 | 2014-06-30 |
| 1609205988 | Robyn Maley | Psychologist | 100 4th St S, Fargo, ND 58103-1929 | 2013-11-06 |
| 1699102897 | Lindsey Marie Sloan Peterson | Nurse Practitioner | 100 4th St S, Fargo, ND 58103-1929 | 2013-10-02 |
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| 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 | 103TP0814X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Psychoanalysis |
| (1) A practitioner of psychoanalysis: methods of eliciting from patients their past emotional experiences and their role in influencing their current mental life, in order to discover the conflicts and mechanisms by which their pathologic mental state has been produced and to furnish hints for psychotherapeutic procedures, the method employs free association, recall and interpretation of dreams and interpretation of transference and resistance phenomena; (2) An individual who is educated with a doctor’s degree in psychoanalysis or psychology, trained at an established psychoanalytic institute, and practices or adheres to the principles of psychoanalysis. Psychoanalysis is a form of psychotherapy and a system of investigation for determining and understanding mental processes, which was originally conceived by Sigmund Freud. Psychoanalysis involves the analysis and interpretation of dreams, resistances, and transferences, and uses free association and catharsis. Clinical practice requires licensure. |
| Notes: Sources: (1) Dorlands Illustrated Medical Dictionary, 28th Edition, W.B. Saunders Company: Philadelphia, 1994, p. 1382; (2)American Psychological Association, Washington, DC, 1997, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245494764 | Stephen A Kisslinger | Psychologist | 100 4th St S, Fargo, ND 58103-1929 | 2008-07-14 |
| 1629265814 | Paul B Revland | Psychologist | 1720 University Dr S, Fargo, ND 58103-4940 | 2007-10-02 |
| 1972525525 | Ann K Sandgren | Psychologist | 820 4th St N, Fargo, ND 58122-0001 | 2006-07-24 |
| 1952323529 | David John Tupa | Psychologist | 100 4th St S, Fargo, ND 58103-1929 | 2006-07-24 |
| 1760403984 | Pamela Marie Samson | Psychologist | 1720 University Dr S, Fargo, ND 58103-4940 | 2006-07-22 |
| 1093736217 | Lorraine A Swan-kremeier | Psychologist | 100 4th St S, Fargo, ND 58103-1929 | 2006-07-22 |
| 1689695926 | Margo R Norton | Psychologist | 737 Broadway N, Fargo, ND 58122-0001 | 2006-07-22 |
| 1114948452 | Jon C Ulven | Psychologist | 1720 University Dr S, Fargo, ND 58103-4940 | 2006-07-22 |
| 1154349884 | Kenneth E Christianson | Psychologist | 737 Broadway N, Fargo, ND 58122-0001 | 2006-07-18 |
| 1023035797 | Ryan D Jagim | Psychologist | 100 4th St S, Fargo, ND 58103-1929 | 2006-07-17 |
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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.