Healthcare Provider Details

I. General information

NPI: 1740556414
Provider Name (Legal Business Name): MRS. TALITHA K SCHNAIDT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2012
Last Update Date: 05/21/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 S 4TH ST SUITE 401
GRAND FORKS ND
58201-4715
US

IV. Provider business mailing address

1312 ND-49
BEULAH ND
58523
US

V. Phone/Fax

Practice location:
  • Phone: 701-795-3150
  • Fax:
Mailing address:
  • Phone: 701-873-4445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number586-7-15-07
License Number StateND
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number586-7-15-07-455
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: