1912508243 NPI number — MRS. ARIANA BARBARA KAY KRECKLAU LMSW, LGSW

Table of content: MRS. ARIANA BARBARA KAY KRECKLAU LMSW, LGSW (NPI 1912508243)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912508243 NPI number — MRS. ARIANA BARBARA KAY KRECKLAU LMSW, LGSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KRECKLAU
Provider First Name:
ARIANA
Provider Middle Name:
BARBARA KAY
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMSW, LGSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KIMBLE
Provider Other First Name:
ARIANA
Provider Other Middle Name:
BARBARA KAY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1912508243
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/11/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3244 51ST ST S
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FARGO
Provider Business Mailing Address State Name:
ND
Provider Business Mailing Address Postal Code:
58104-7179
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
701-356-0062
Provider Business Mailing Address Fax Number:
701-356-5412

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3244 51ST ST S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FARGO
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58104-7179
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-356-0062
Provider Business Practice Location Address Fax Number:
701-356-5412
Provider Enumeration Date:
11/03/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  5869 , registered in the state of ND ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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