Healthcare Provider Details

I. General information

NPI: 1538946066
Provider Name (Legal Business Name): GAYLE HELGESON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: GAYLE DOUGHERTY

II. Dates (important events)

Enumeration Date: 09/08/2023
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 OAK ST N APT 1
FARGO ND
58102-3931
US

IV. Provider business mailing address

502 OAK ST N APT 1
FARGO ND
58102-3931
US

V. Phone/Fax

Practice location:
  • Phone: 701-306-7824
  • Fax:
Mailing address:
  • Phone: 701-306-7824
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-22714
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: