MEDICARE: LUKE J. KLEFSTAD LPCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	428-9-1-99	ND
2	101YP2500X	Professional Counselor	428-9-1-99-237	ND

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	450226423	OTHER	ND	FEDERAL TAX ID
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104837251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUKE J. KLEFSTAD LPCC

Provider Business Mailing Address
First Line	:	2701 12TH AVE S
Second Line	:
City	:	FARGO
State	:	ND
Zip	:	58103-8753
Country	:	US
Telephone Number	:	701-451-4900
Fax Number	:	651-925-0057

Provider Business Practice Location Address
First Line	:	4324 UNIVERSITY AVE STE B
Second Line	:
City	:	GRAND FORKS
State	:	ND
Zip	:	58203-1938
Country	:	US
Telephone Number	:	701-746-4584
Fax Number	:	651-925-0057

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	02/23/2026

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