Healthcare Provider Details

I. General information

NPI: 1821372947
Provider Name (Legal Business Name): JONI LYNN HUBRIG LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JONI LYNN DANIELSON LICSW

II. Dates (important events)

Enumeration Date: 10/07/2011
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1313 30TH AVE S
MOORHEAD MN
56560-5106
US

IV. Provider business mailing address

PO BOX 2010
FARGO ND
58122-0605
US

V. Phone/Fax

Practice location:
  • Phone: 218-284-3713
  • Fax:
Mailing address:
  • Phone: 701-234-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number15361
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4508
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: