MIDWEST MENTAL HEALTH CLINIC PLLC
NPI 1861877052
Nurse Practitioner - Psychiatric/Mental Health in Fargo, ND
NPI Status: Active since July 29, 2015
Contact Information
1122 1ST AVE N
FARGO, ND
ZIP 58102
Phone: (218) 477-1353
Fax: (218) 477-1354
- Organization
- Nurse Practitioner
- Psychiatric/Mental Health
- Accepts Insurance
- CLIA Number: 35D2261130
- CLIA Cert. Type: Practitioner Other
- CLIA Exp. Date: 05-25-2026
About MIDWEST MENTAL HEALTH CLINIC PLLC
This page provides the complete NPI Profile along with additional information for Midwest Mental Health Clinic Pllc, a provider established in Fargo, North Dakota operating as a Nurse Practitioner, focusing in psychiatric/mental health . The healthcare provider is registered in the NPI registry with number 1861877052 assigned on July 2015. The practitioner's primary taxonomy code is 363LP0808X with license number CNP3899 (MN). The provider is registered as an organization and their NPI record was last updated 3 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Jacqualine Gervais Pmhnp (Owner)
- NPI
- 1861877052
- Provider Name
- MIDWEST MENTAL HEALTH CLINIC PLLC
- Entity Type
- Organization
- Location Address
- 1122 1ST AVE N FARGO, ND 58102
- Location Phone
- (218) 477-1353
- Location Fax
- (218) 477-1354
- Mailing Address
- 819 30TH AVE S OFFICE 206 SUITE B MOORHEAD, MN 56560
- Mailing Phone
- (218) 477-1353
- Mailing Fax
- (218) 477-1354
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 07-29-2015
- Last Update Date
- 01-17-2023
- Code Navigator
A nurse practitioner (NP) like Midwest Mental Health Clinic Pllc is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Location Map
Secondary Locations
- 819 30th Ave S Office 206 Suite B
Moorhead, MN 56560
(218) 477-1353 - 5306 Ballard Ave NW Ste 208
Seattle, WA 98107
(218) 477-1353 - 1829 S Broadway Ste 4
Minot, ND 58701
(218) 477-1353
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Practitioner Psychiatric/Mental Health
- Taxonomy Code
- 363LP0808X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- CNP3899
- License State
- MN
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BlueCare Bronze HSA Eligible $50 PCP Copay ($5 Value Based Drug List) - PPO
- BlueCare Gold $10 PCP Copay ($5 Value Based Drug List) - PPO
- BlueCare Silver $20 PCP Copay ($5 Value Based Drug List) - PPO
- BlueDirect Bronze 100 HSA Eligible ($8000 Deductible / $5 Preventive Drug List) - PPO
- BlueDirect Gold 90 HSA Eligible ($2600 Deductible / $5 Preventive Drug List) - PPO
- BlueDirect Silver 80 HSA Eligible ($3500 Deductible / $5 Preventive Drug List) - PPO
- BlueEssential Catastrophic 100 HSA Eligible $10600 Deductible - PPO
- BlueValue Bronze HSA Eligible $50 PCP Copay (Standardized plan) - PPO
- BlueValue Gold $30 PCP Copay (Standardized plan) - PPO
- BlueValue Silver $40 PCP Copay (Standardized plan) - PPO
- DakotaBlue Altru Gold ($5 Value Based Drug List) - PPO
- DakotaBlue Altru Silver ($5 Value Based Drug List) - PPO
- DakotaBlue Trinity Gold ($5 Value Based Drug List) - PPO
- DakotaBlue Trinity Silver ($5 Value Based Drug List) - PPO
- Atlas $1,300 Gold - PPO
- Atlas $2,000 Standard Gold - PPO
- Atlas $3,050 Plus Silver - PPO
- Atlas $3,800 HSA Silver - PPO
- Atlas $6,000 Standard Silver - PPO
- Atlas $6,800 Plus Bronze HSA - PPO
- Atlas $7,500 Standard Bronze HSA - PPO
- Atlas $8,400 HSA Bronze - PPO
- Altru Prime by Medica Bronze $0 Copay PCP Visits - HMO
- Altru Prime by Medica Bronze Share - HMO
- Altru Prime by Medica Expanded Bronze Standard - HMO
- Altru Prime by Medica Gold $0 Copay PCP Visits - HMO
- Altru Prime by Medica Gold Share - HMO
- Altru Prime by Medica Gold Standard - HMO
- Altru Prime by Medica Silver $0 Copay PCP Visits - HMO
- Altru Prime by Medica Silver Share - HMO
- Altru Prime by Medica Silver Standard - HMO
- Essentia Choice Care with Medica Bronze $0 Copay PCP Visits - HMO
- Essentia Choice Care with Medica Bronze Share - HMO
- Essentia Choice Care with Medica Expanded Bronze Standard - HMO
- Essentia Choice Care with Medica Gold $0 Copay PCP Visits - HMO
- Essentia Choice Care with Medica Gold Share - HMO
- Essentia Choice Care with Medica Gold Standard - HMO
- Essentia Choice Care with Medica Silver $0 Copay PCP Visits - HMO
- Essentia Choice Care with Medica Silver Share - HMO
- Essentia Choice Care with Medica Silver Standard - HMO
- Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
- Medica Individual Choice Bronze Share - HMO
- Premera Blue Cross Alaska One Gold - PPO
- Premera Blue Cross Preferred Bronze 5800 HSA - PPO
- Premera Blue Cross Preferred Bronze 6350 - PPO
- Premera Blue Cross Preferred Gold 1500 - PPO
- Premera Blue Cross Preferred Silver 4500 - PPO
- Premera Blue Cross Standard Bronze II - PPO
- Premera Blue Cross Standard Gold - PPO
- Premera Blue Cross Standard Silver - PPO
- Premera Blue Cross Family Dental - PPO
- Premera Blue Cross Pediatric Dental - PPO
- Sanford Individual TRUE $1,750 - HMO
- Sanford Individual TRUE $10,600 - HMO
- Sanford Individual TRUE $3,500 - HMO
- Sanford Individual TRUE $4,750 - HMO
- Sanford Individual TRUE $6,500 - HMO
- Sanford Individual TRUE $7,200 HSA Qualified - HMO
- Sanford Individual TRUE Standardized $2,000 - HMO
- Sanford Individual TRUE Standardized $6,000 - HMO
- Sanford Individual TRUE Standardized $7,500 - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 35D2261130
- Facility Type
- Practitioner Other
- Certificate Effective Date
- May 26, 2024
- Certificate Expiration Date
- May 25, 2026
- Laboratory Director
- JACQUALINE K. GERVAIS
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Midwest Mental Health Clinic Pllc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for MIDWEST MENTAL HEALTH CLINIC PLLC
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1861877052, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 58 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
FARGO, ND 58102
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1861877052, enumerated as an "organization" on July 29, 2015.
The provider is located at 1122 1ST AVE N FARGO, ND 58102 and the phone number is (218) 477-1353.
Nurse Practitioner with taxonomy code 363LP0808X and a focus in Psychiatric/Mental Health.
The provider might be accepting Accepts: Blue Cross Blue Shield of North Dakota,. Please consult your insurance carrier or call the provider to verify.
