Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Cornervine Counseling, PLLC

Organization Clinical Social Worker · NPI 1184423121

Cornervine Counseling, PLLC is a Clinical Social Worker in Fargo, North Dakota. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

624 Main Ave Ste 3A
Fargo, ND 58103-1966
Phone: (701) 373-1149
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X

Record details

NPI number1184423121
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Amber Mutalipassi — Owner · (701) 773-3381
NPI enumeratedMarch 11, 2025
Last updated in NPPESMarch 27, 2025
Certification dateMarch 27, 2025
Mailing address624 Main Ave Ste 3a, Fargo, ND 58103-1966

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