Individual
CHARLIE RAY HYSTAD-MOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2224 1ST AVE W STE 4, WILLISTON, ND 58801-6286
(701) 572-3335
(701) 572-3337
Mailing address
2224 1ST AVE W STE 4, WILLISTON, ND 58801-6286
(701) 572-3335
(701) 572-3337
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
5334
ND
Other
Enumeration date
04/26/2018
Last updated
01/11/2026
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