Madison Lauren Brazeel, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

1947 Issued in ND

Practice address

2625 N 19TH St
Bismarck, ND 58503-0574

Phone

(701) 222-3175

Fax

(701) 222-3186

NPI assigned

Aug 30, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Red Door Pediatric Therapy, Inc

  • Speech-Language Pathologist
  • Bismarck, ND
  • NPI 1639257033
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1023590643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 N 19TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585030574",
            "telephone_number": "701-222-3175",
            "fax_number": "701-222-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 N 19TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585030574",
            "telephone_number": "701-222-3175",
            "fax_number": "701-222-3186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAZEEL",
        "first_name": "MADISON",
        "middle_name": "LAUREN",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-30",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "RBT-18-64141",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "1947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1483045",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allison Braun
• Brandi Lynn Braun, NP
• Josephine Braun, LBSW, TCM
• Kristin Braun, FNP
• Mandi L Braun, PA-C
• Breakaway Functional Medicine
• Breaking Barriers Therapy, PLLC
• Breakthrough Counseling Services PLLC
• Zoie B Breckheimer, OTR/L
• Sarah Breen, PA-C

• Speech-Language Pathologist in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Speech-Language Pathologist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.