Individual provider · Type 1 NPI

Charlie Ray Hystad-Moe, LCSW

Clinical Social Worker · Williston, ND

NPI number 1407344286 Active

Practice location

2224 1st Ave W Ste 4
Williston, ND 58801-6286

Call (701) 572-3335 Map

Fax (701) 572-3337

Other practice locations

  • 5598 145th Ave NW, Williston, ND 58801-9033 · (701) 695-2226

Specialties and licenses

TaxonomyCodeLicense
Social Worker 104100000XNone listed
Clinical Social Worker Primary 1041C0700X5334 (ND)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1407344286

Charlie Ray Hystad-Moe, LCSW's National Provider Identifier is 1407344286, issued on Apr 26, 2018. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Williston, ND. The record was last updated on Jan 11, 2026.