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Individual

KATHERINE EBACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
316 2ND AVE W, WILLISTON, ND 58801-5218
(701) 302-8888
Mailing address
5147 44TH ST S, FARGO, ND 58104-6069
(701) 226-0848

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
993-3-1-19-496
ND
101YM0800X
Mental Health Counselor
Primary
993-3-1-19A
ND
101YP2500X
Professional Counselor
Primary
993-3-1-19-496
ND

Other

Enumeration date
04/09/2019
Last updated
04/02/2026
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