Shea Brogren
Mental Health
102 W Beaton Dr Ste 105
West Fargo
, North Dakota 58078
Shea Brogren
Mental Health
102 W Beaton Dr Ste 105
West Fargo
, North Dakota 58078
(701) 540-9044
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About
Features
Specialties
- Mental Health
Languages spoken
- English
Location
First Address
- Shea Brogren
- 3507 Evergreen Rd N
- Fargo, ND
- Zip : 58102-1218
- Fax : (701) 540-9044
- Phone : (701) 261-4643
Second Address
- Shea Brogren
- 102 W Beaton Dr Ste 105
- West Fargo, ND
- Zip : 58078
- Fax : (701) 540-9044
- Phone : (701) 261-4643
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 225XM0800X | Mental Health | 1351 | ND |
National Provider Identifier
| NPI | 1578979241 |
|---|---|
| Provider Name | Shea Brogren |
| First Address | Fargo, ND 58102-1218 |
| Second Address | West Fargo, ND 58078 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/07/2014 |
| Last Update Date | 16/10/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 56430 | (05) | ND |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.