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Contact Information

SANDRA M IVERSON, LICSW
4624 154TH AVE NW
WILLISTON, ND58801
 Phone: 701-651-6352
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Social Worker

104100000X
Indicates primary specialty

NPI Profile & details for SANDRA M IVERSON · (Female)

NPI # 1730339326
Status Active
Credentials LICSW (Licensed Independent Clinical Social Worker)
Entity Individual
Enumeration date 09/19/2008
Last updated 10/20/2017 - About 9 years ago
Sole proprietor 1 Yes
Identifiers
  • ND License # 4265
  • ND Medicaid 54516
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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