Healthcare Provider Details

I. General information

NPI: 1932836293
Provider Name (Legal Business Name): ETS COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2022
Last Update Date: 06/12/2023
Certification Date: 06/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1351 PAGE DR S STE 212
FARGO ND
58103-3536
US

IV. Provider business mailing address

1351 PAGE DR S STE 212
FARGO ND
58103-3536
US

V. Phone/Fax

Practice location:
  • Phone: 701-793-2812
  • Fax: 701-343-1319
Mailing address:
  • Phone: 701-793-2812
  • Fax: 701-343-1319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: LISA RORVIG
Title or Position: OWNER
Credential:
Phone: 218-329-9502