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

Mya Gietzen

Individual provider Clinical Social Worker · NPI 1992561625

Mya Gietzen is a Clinical Social Worker in Moorhead, Minnesota. Qualified in 2023, 3 years ago. Practices with Sanford Medical Center Fargo, a 1,212-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Minnesota and North Dakota.

Years since qualifying
3
Licensed in
MN, ND
In the registry since
2024
Specialties on file
3
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Practice location Address checks out

4000 28th Ave S
Moorhead, MN 56560-7926
Phone: (701) 234-3200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 801 Broadway N, Fargo, ND 58102-3641 — (701) 234-2000

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 35469 (MN)
Clinical Social Worker Taxonomy 1041C0700X · Licence 6684 (ND)
Social Worker Taxonomy 104100000X · Licence 6684 (ND)

Record details

NPI number1992561625
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 21, 2024
Last updated in NPPESMarch 3, 2026
Certification dateMarch 3, 2026
Mailing addressPo Box 5074, Sioux Falls, SD 57117-5074

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Sanford Medical Center Fargo — 1212 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Moorhead