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

Mr. Gerard W Kottenbrock, LICSWLAC

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1528161189

Mr. Gerard W Kottenbrock, LICSWLAC is an Addiction (Substance Use Disorder) Counselor in Fargo, North Dakota. Licensed in North Dakota. Registered with an NPI since 2006.

Licensed in
ND
In the registry since
2006
Specialties on file
2

Practice location Address checks out

510 4th St S
Fargo, ND 58103
Phone: (701) 476-7240
Fax: (701) 476-7269
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 1540 (ND)
Clinical Social Worker Taxonomy 1041C0700X · Licence LICSW1832 (ND)

Record details

NPI number1528161189
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSWLAC
Sole proprietorNo
NPI enumeratedSeptember 7, 2006
Last updated in NPPESSeptember 11, 2025

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