Organization
REDEEMING GRACE COUNSELING PLLC
Active
Other names
Redeeming Grace Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER LENORE ANDERSON MSW, LICSW (PRESIDENT)
(701) 353-9979
Entity
Organization
Contact information
Practice address
1351 PAGE DR S, FARGO, ND 58103-3502
(701) 353-9979
(701) 639-6501
Mailing address
1351 PAGE DR S STE 202, FARGO, ND 58103-3536
(701) 353-9979
(701) 639-6501
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12696273
CAQH
—
05
—
19344
—
ND
01
—
1942625983
NPI
—
01
—
N711952
MEDICARE
—
Enumeration date
11/11/2018
Last updated
07/01/2020
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