Healthcare Provider Details

I. General information

NPI: 1265736771
Provider Name (Legal Business Name): CLANCI MARIE BARNHART MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2010
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 ELM ST N
FARGO ND
58102-2417
US

IV. Provider business mailing address

3275 W RIDGE DR
DICKINSON ND
58601-5364
US

V. Phone/Fax

Practice location:
  • Phone: 701-239-3700
  • Fax: 701-237-2642
Mailing address:
  • Phone: 701-540-2778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4365
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: