Healthcare Provider Details

I. General information

NPI: 1609714930
Provider Name (Legal Business Name): INNER COMPASS COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3577 49TH ST S
FARGO ND
58104-4494
US

IV. Provider business mailing address

3577 49TH ST S
FARGO ND
58104-4494
US

V. Phone/Fax

Practice location:
  • Phone: 701-793-2129
  • Fax:
Mailing address:
  • Phone: 701-793-2129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: JOELY DAVIDSON
Title or Position: MENTAL HEALTH THERAPIST
Credential: LPCC
Phone: 701-793-2129