IndividualActive
Bryan Bloemendaal, MS, LAC
NPI 1245784156 · Addiction (Substance Use Disorder) Counselor · Fargo, ND
Provider details
- NPI number
- 1245784156
- Entity type
- Individual
- Primary specialty
- Addiction (Substance Use Disorder) CounselorBehavioral Health & Social Service Providers
- Credential
- MS, LAC
- Sex
- Male
- Sole proprietor
- Yes
- License
- 304586 (MN)
Mailing address
5050 40th Ave S
Fargo, ND 58104-8906
Registry dates
- Enumerated
- 2016-08-09
- Last updated
- 2016-08-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.