Healthcare Provider Details

I. General information

NPI: 1477955144
Provider Name (Legal Business Name): MARY KATHARINE EPPING LAC, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARY KATHARINE CROMPTON LICSW LAC

II. Dates (important events)

Enumeration Date: 09/24/2014
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1635 43RD ST S STE 105
FARGO ND
58103-3579
US

IV. Provider business mailing address

1547 30TH AVE S
MOORHEAD MN
56560-5149
US

V. Phone/Fax

Practice location:
  • Phone: 218-287-4338
  • Fax: 218-287-0643
Mailing address:
  • Phone: 218-287-4338
  • Fax: 218-512-0643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1643
License Number StateND
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4004
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: