DR. KELLY CRAGHILL FAGERBURG SMITH PSYD
NPI 1376896803
Psychologist in Fargo, ND

Active since October 22, 2012PECOS Enrolled
1308 23RD ST S, FARGO, ND 58103(701) 297-7540(701) 297-6439 Get Directions Write a Review

NPPES record last updated: March 11, 2015. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Kelly Craghill Fagerburg Smith Psyd NPPES

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

DR. KELLY CRAGHILL FAGERBURG SMITH PSYD (NPI 1376896803) is an individual psychologist in Fargo, North Dakota, licensed in North Dakota (473) and active in the NPI registry since October 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1376896803
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. KELLY CRAGHILL FAGERBURG SMITHCredential: PSYD
Location Address1308 23RD ST SFargo, ND 58103-3707
Mailing Address1308 23rd St SFargo, ND 58103-3707 · (701) 297-7540 · Fax (701) 297-6439
Fax(701) 297-6439
Sole ProprietorNo
Enumeration DateOctober 22, 2012
Last NPPES UpdateMarch 11, 2015
NPI 1376896803 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in ND · 473
Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License 473 (ND)
1308 23RD ST S, Fargo, ND 58103

Other Identifiers 2

Medicare UPINN719250ND
Medicaid17313ND

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Kelly Craghill Fagerburg Smith Psyd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Social Worker (Clinical)
1308 23RD ST S, SUITE G
FARGO, ND 58103
Community/Behavioral Health
1308 23RD ST S, SUITE G
FARGO, ND 58103
Psychologist
1308 23RD ST S
FARGO, ND 58103

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1376896803, enumerated as an "individual" on October 22, 2012.

The provider is located at 1308 23RD ST S FARGO, ND 58103 and the phone number is (701) 297-7540.

Psychologist with taxonomy code 103T00000X.

The provider might be accepting Accepts: Blue Cross Blue Shield of North Dakota, Sanford. Please consult your insurance carrier or call the provider to verify.