MEDICARE: COMMUNITY VIOLENCE INTERVENTION CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1346781747
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY VIOLENCE INTERVENTION CENTER INC

Provider Business Mailing Address
First Line	:	211 S 4TH ST
Second Line	:
City	:	GRAND FORKS
State	:	ND
Zip	:	58201-4737
Country	:	US
Telephone Number	:	701-746-0405
Fax Number	:	701-746-5918

Provider Business Practice Location Address
First Line	:	211 S 4TH ST
Second Line	:
City	:	GRAND FORKS
State	:	ND
Zip	:	58201-4737
Country	:	US
Telephone Number	:	701-746-0405
Fax Number	:	701-746-5918

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. KRISTI HALL-JIRAN
Credential	:	LPCC
Telephone Number	:	701-746-0405

Provider Enumeration Date	:	03/17/2017
Last Update Date	:	07/31/2025

Similar Medicare Providers

1366393324 — MADISON PHILLIPS-BISCHOFF
Practice Location Address:

211 S 4TH ST
GRAND FORKS, ND
58201-4737

Practice Phone: 701-746-0405
Practice Fax: 701-746-5918

1316140346 — DR. DAVID H. WHITCOMB PH.D.
Practice Location Address:

217A S 4TH ST STE 202
GRAND FORKS, ND
58201-4737

Practice Phone: 701-772-1588
Practice Fax:

1619201092 — FELIX ESEQUIEL CABALLERO LMHC
Practice Location Address:

211 S 4TH ST
GRAND FORKS, ND
58201-4737

Practice Phone: 701-746-0405
Practice Fax: 701-746-5918

1861860322 — DEBRA CAMPERUD
Practice Location Address:

215 S 4TH ST
GRAND FORKS, ND
58201-4737

Practice Phone: 701-740-6506
Practice Fax:

1326589730 — MS. THERESE HUGG LPC
Practice Location Address:

211 S 4TH ST
GRAND FORKS, ND
58201-4737

Practice Phone: 701-746-0405
Practice Fax: 701-746-5918

1215461942 — JENNA HOLTZ
Practice Location Address:

211 S 4TH ST
GRAND FORKS, ND
58201-4737

Practice Phone: 701-746-0405
Practice Fax:

Directions to “COMMUNITY VIOLENCE INTERVENTION CENTER INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.