| Shanti Wellness Pllc | |
|
3481 University Dr S Ste 104 Fargo ND 58104-6235 | |
| (701) 353-9238 | |
| (701) 205-1221 |
| Full Name | Shanti Wellness Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 3481 University Dr S Ste 104, Fargo, North Dakota |
| Authorized Official Name and Position | Melissa A Shigematsu (OWNER/THERAPIST) |
| Authorized Official Contact | 7013186551 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shanti Wellness Pllc 3481 University Dr S Ste 104 Fargo ND 58104-6235 Ph: (701) 353-9238 | Shanti Wellness Pllc 3481 University Dr S Ste 104 Fargo ND 58104-6235 Ph: (701) 353-9238 |
| NPI Number | 1033817226 |
|---|---|
| Provider Enumeration Date | 02/17/2023 |
| Last Update Date | 02/17/2023 |
| Certification Date | 02/17/2023 |
| Medicare PECOS PAC ID | 3678933488 |
|---|---|
| Medicare Enrollment ID | O20230712001064 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033817226 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Melissa A Shigematsu |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275083685 PECOS PAC ID: 4688938772 Enrollment ID: I20180425001077 |
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