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SOUTHEAST BEHAVIORAL HEALTH CLINIC
NPI 1295256386
Community/Behavioral Health in Fargo, ND

Active since June 29, 2017CLIA 35D2079903 · Waiver
2624 9TH AVE S, FARGO, ND 58103(701) 298-4500(701) 298-4400 Get Directions Write a Review

NPPES record last updated: March 31, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 31, 2026, Jul 21, 2022, Jun 29, 2017 (3 updates tracked since 2017).

About Southeast Behavioral Health Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHEAST BEHAVIORAL HEALTH CLINIC (NPI 1295256386) is a healthcare organization registered as a community/behavioral health in Fargo, North Dakota and active in the NPI registry since June 2017. The organization holds a CLIA Waiver certificate valid through July 20, 2027 and lists Stenseth Jeff, Director, as its authorized official.

NPPES Registry Identity

NPI1295256386
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameSOUTHEAST BEHAVIORAL HEALTH CLINIC
Location Address2624 9TH AVE SFargo, ND 58103-2350
Mailing Address2624 9th Ave SFargo, ND 58103-2350 · (701) 298-4500 · Fax (701) 298-4400
Phone(701) 298-4500
Fax(701) 298-4400
Organization SubpartNo
Authorized OfficialStenseth JeffDirector · (701) 328-4578
Enumeration DateJune 29, 2017
Last NPPES UpdateMarch 31, 20263 updates tracked since enumeration
NPPES CertifiedMarch 31, 2026
✔ NPI 1295256386 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
2624 9TH AVE S, Fargo, ND 58103
Open in Google Maps ↗

Other Identifiers 1

MedicaidND249518ND

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 35D2079903

Southeast Behavioral Health Clinic - Med Services · Fargo, ND
Active · expires Jul 20, 2027
CLIA Number35D2079903
Laboratory TypeCommunity Clinic
Certificate Effective DateJuly 21, 2025
Certificate Expiration DateJuly 20, 2027
Laboratory DirectorLori J. Esprit
Laboratory Phone(701) 298-4500
Laboratory LocationSoutheast Behavioral Health Clinic - Med Services2624 9th Ave S, Fargo, ND 58103
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNY WEST
Specialist
2624 9TH AVE S
FARGO, ND 58103
Cass County (701) 298-4500
SHAYLA ZASTE TCM
Case Manager/Care Coordinator
2624 9TH AVE S
FARGO, ND 58103
Cass County (701) 595-4861
DETON HART
Counselor (Professional)
2624 9TH AVE S
FARGO, ND 58103
Cass County (701) 298-4500
VALENTINA B ASIEDU MPH, CHES
Case Manager/Care Coordinator
2624 9TH AVE S
FARGO, ND 58103
Cass County (701) 298-4959
MS. SARA L NICOLI M.ED, LAC
Counselor (Addiction (Substance Use Disorder))
2624 9TH AVE S
FARGO, ND 58103
Cass County (701) 298-4500
DALE A CARRIER LPCC
Counselor
2624 9TH AVE S
FARGO, ND 58103
Cass County (701) 298-4500
JENNIFER LEONE MULLEN LSW
Social Worker
2624 9TH AVE S
FARGO, ND 58103
Cass County (701) 298-4500
TRACY DIEDRICH
Case Manager/Care Coordinator
2624 9TH AVE S
FARGO, ND 58103
Cass County (701) 298-4500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southeast Behavioral Health Clinic's NPI number?

The NPI number for Southeast Behavioral Health Clinic is 1295256386. It was assigned to this organization in the NPPES registry on June 29, 2017.

Where is Southeast Behavioral Health Clinic located?

Southeast Behavioral Health Clinic is located at 2624 9th Ave S, Fargo, ND 58103. The listed phone number is (701) 298-4500.

What is Southeast Behavioral Health Clinic's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Does Southeast Behavioral Health Clinic hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 35D2079903) is associated with this NPI, valid through July 20, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Southeast Behavioral Health Clinic was last updated on March 31, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.