Provider Demographics
NPI:1437286762
Name:PACHL, JODI (LCSW)
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:PACHL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 1ST ST E STE 19
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:ND
Mailing Address - Zip Code:58601-5266
Mailing Address - Country:US
Mailing Address - Phone:701-800-0750
Mailing Address - Fax:
Practice Address - Street 1:26 1ST ST E STE 19
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:ND
Practice Address - Zip Code:58601-5266
Practice Address - Country:US
Practice Address - Phone:701-800-0750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND59631041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical