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MIDWEST MENTAL HEALTH CLINIC PLLC
NPI 1861877052
Nurse Practitioner - Psychiatric/Mental Health in Fargo, ND

Active since July 29, 2015
1122 1ST AVE N, FARGO, ND 58102(218) 477-1353(218) 477-1354 Get Directions Write a Review

NPPES record last updated: January 17, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 17, 2023, Sep 9, 2021 (2 updates tracked since 2021).

About Midwest Mental Health Clinic Pllc NPPES

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

MIDWEST MENTAL HEALTH CLINIC PLLC (NPI 1861877052) is a healthcare organization registered as a psychiatric/mental health in Fargo, North Dakota and active in the NPI registry since July 2015. The organization maintains 3 additional practice locations and lists Jacqualine Gervais, Owner, as its authorized official.

NPPES Registry Identity

NPI1861877052
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameMIDWEST MENTAL HEALTH CLINIC PLLC
Location Address1122 1ST AVE NFargo, ND 58102-4604
Mailing Address819 30th Ave S Office 206 Suite BMoorhead, MN 56560 · (218) 477-1353 · Fax (218) 477-1354
Phone(218) 477-1353
Fax(218) 477-1354
Organization SubpartNo
Authorized OfficialJacqualine GervaisOwner · (218) 477-1353
Enumeration DateJuly 29, 2015
Last NPPES UpdateJanuary 17, 20232 updates tracked since enumeration
NPPES CertifiedJanuary 17, 2023
✔ NPI 1861877052 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in MN · CNP3899
1122 1ST AVE N, Fargo, ND 58102
Open in Google Maps ↗

Secondary Practice Locations 3

Location 1819 30th Ave S Office 206 Suite BMoorhead, MN 56560 · Phone (218) 477-1353 · Fax (218) 477-1354
Location 25306 Ballard Ave NW Ste 208Seattle, WA 98107-4366 · Phone (218) 477-1353
Location 31829 S Broadway Ste 4Minot, ND 58701-6571 · Phone (218) 477-1353 · Fax (218) 477-1354

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of North Dakota, HealthPartners, Medica and more.Insurance ›

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.

TARA HART
Peer Specialist
1122 1ST AVE N
FARGO, ND 58102
Cass County (701) 210-2491
JENNIFER SEVIOUR
Case Manager/Care Coordinator
1122 1ST AVE N
FARGO, ND 58102
Cass County (701) 210-2491
CODY BENARD STANLEY
Case Manager/Care Coordinator
1122 1ST AVE N
FARGO, ND 58102
Cass County (701) 210-2491
ANGEL WHITEHEAD
Peer Specialist
1122 1ST AVE N
FARGO, ND 58102
Cass County (701) 317-1820
JAMES REYNOLDS
Case Manager/Care Coordinator
1122 1ST AVE N
FARGO, ND 58102
Cass County (701) 210-2491
ERLENE BENJAMIN
Case Manager/Care Coordinator
1122 1ST AVE N
FARGO, ND 58102
Cass County (218) 304-2242
STEVEN MORRIS
Peer Specialist
1122 1ST AVE N
FARGO, ND 58102
Cass County (701) 317-1820
MATT QUINN
Case Manager/Care Coordinator
1122 1ST AVE N
FARGO, ND 58102
Cass County (701) 210-2491

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 Midwest Mental Health Clinic PLLC's NPI number?

The NPI number for Midwest Mental Health Clinic PLLC is 1861877052. It was assigned to this organization in the NPPES registry on July 29, 2015.

Where is Midwest Mental Health Clinic PLLC located?

Midwest Mental Health Clinic PLLC is located at 1122 1st Ave N, Fargo, ND 58102. The listed phone number is (218) 477-1353.

What is Midwest Mental Health Clinic PLLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

What insurance does Midwest Mental Health Clinic PLLC accept?

Health plans from Blue Cross Blue Shield of North Dakota, HealthPartners, Medica, Premera Blue Cross Blue Shield of Alaska and Sanford Health Plan list Midwest Mental Health Clinic PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Midwest Mental Health Clinic PLLC was last updated on January 17, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.