Provider Demographics
NPI:1679217194
Name:STROMSODT, MICHELLE LYNN (LAPC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LYNN
Last Name:STROMSODT
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:VAN CAMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 9859
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58106-9859
Mailing Address - Country:US
Mailing Address - Phone:701-451-4900
Mailing Address - Fax:651-925-0057
Practice Address - Street 1:3220 4TH ST E STE 102
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-3082
Practice Address - Country:US
Practice Address - Phone:701-501-7449
Practice Address - Fax:701-425-0322
Is Sole Proprietor?:No
Enumeration Date:2022-04-21
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND101YM0800X
ND1203-6-15-22A101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health