1679635312 NPI number — MRS. DANIELLE HELGESON MS,CCC-SLP

Table of content: MRS. DANIELLE HELGESON MS,CCC-SLP (NPI 1679635312)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679635312 NPI number — MRS. DANIELLE HELGESON MS,CCC-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HELGESON
Provider First Name:
DANIELLE
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MS,CCC-SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MARQUART
Provider Other First Name:
DANIELLE
Provider Other Middle Name:
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1679635312
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/18/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1311 S WASHINGTON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRAND FORKS
Provider Business Mailing Address State Name:
ND
Provider Business Mailing Address Postal Code:
58201-5406
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
701-317-2897
Provider Business Mailing Address Fax Number:
701-213-4345

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3535 S 31ST ST STE 105
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GRAND FORKS
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58201-3592
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-317-2897
Provider Business Practice Location Address Fax Number:
701-213-4345
Provider Enumeration Date:
12/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  826 , registered in the state of ND ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 46-00808 . This is a "MEDICA PROVIDER NUMBER" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
  • Identifier: B17341047565 . This is a "PREFERREDONE PIN NUMBER" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
  • Identifier: 248618000 . This is a "MHCP" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 2239195 . This is a "FIRST HEALTH" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
  • Identifier: 54526 , issued by the state of ( ND ) . This identifiers is of the category "MEDICAID".
  • Identifier: HEL23282 . This is a "BCBS ND PROVIDER NUMBER" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".




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