Healthcare Provider Details

I. General information

NPI: 1831844349
Provider Name (Legal Business Name): MARTINSEN BEHAVIORAL HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2022
Last Update Date: 03/15/2023
Certification Date: 03/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2116 4TH AVE NW STE 100
MINOT ND
58703-2967
US

IV. Provider business mailing address

2116 4TH AVE NW STE 100
MINOT ND
58703-2967
US

V. Phone/Fax

Practice location:
  • Phone: 701-838-2112
  • Fax: 701-838-2115
Mailing address:
  • Phone: 701-838-2112
  • Fax: 701-838-2115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VII. Legacy identifiers

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

# 1
IdentifierN731150
Identifier TypeOTHER
Identifier StateND
Identifier IssuerMEDICARE
# 2
Identifier1485670
Identifier TypeMEDICAID
Identifier StateND
Identifier Issuer

VIII. Authorized Official

Name: DR. DELLA ANN MARTINSEN
Title or Position: LICENSED PSYCHOLOGIST
Credential: PHD
Phone: 701-838-2112