Provider Demographics
NPI:1598930109
Name:ANNE CARLSEN CENTER
Entity type:Organization
Organization Name:ANNE CARLSEN CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-952-5195
Mailing Address - Street 1:2200 20TH ST SW
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:ND
Mailing Address - Zip Code:58401-7500
Mailing Address - Country:US
Mailing Address - Phone:701-952-5142
Mailing Address - Fax:701-952-1450
Practice Address - Street 1:2200 20TH ST SW
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:ND
Practice Address - Zip Code:58401-7500
Practice Address - Country:US
Practice Address - Phone:701-952-5142
Practice Address - Fax:701-952-1450
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANNE CARLSEN CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-24
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND23204OtherBLUE SHIELD
ND54469Medicaid
ND05919001OtherBLUE SHIELD