Healthcare Provider Details
I. General information
NPI: 1376185967
Provider Name (Legal Business Name): CASSONDRA BADKE LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/15/2019
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2910 7TH ST SW
MINOT ND
58701-7025
US
IV. Provider business mailing address
2910 7TH ST SW
MINOT ND
58701-7025
US
V. Phone/Fax
- Phone: 701-833-1246
- Fax:
- Phone: 701-833-1246
- Fax: 701-335-7106
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 1294-6-1-23-560 |
| License Number State | ND |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: