Provider Demographics
NPI:1437460987
Name:TONSFELDT, DARRIN
Entity Type:Individual
Prefix:
First Name:DARRIN
Middle Name:
Last Name:TONSFELDT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 MAIN AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-1956
Mailing Address - Country:US
Mailing Address - Phone:701-541-5831
Mailing Address - Fax:701-235-6706
Practice Address - Street 1:417 MAIN AVE STE 302
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-1956
Practice Address - Country:US
Practice Address - Phone:701-541-5831
Practice Address - Fax:701-235-6706
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND443-5-1-00-337101YP2500X
ND443-5-1-00101YP2500X
MN3591103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional