Provider Demographics
NPI:1134426463
Name:POSPISHIL AND ASSOCIATES, PLLC
Entity type:Organization
Organization Name:POSPISHIL AND ASSOCIATES, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:F
Authorized Official - Last Name:POSPISHIL
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:701-858-0888
Mailing Address - Street 1:PO BOX 427
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58702-0427
Mailing Address - Country:US
Mailing Address - Phone:701-858-0888
Mailing Address - Fax:
Practice Address - Street 1:1425 21ST AVE NW
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58703-0816
Practice Address - Country:US
Practice Address - Phone:701-858-0888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-23
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1396144366Medicaid