Elaine Doerfler, MS, CCC/SLP
Individual provider Active NPI Speech-Language Pathologist · West Fargo, ND
NPI 1124388731 · NPPES record last updated Jun 16, 2022
Key facts
- NPI
- 1124388731
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 1212 (ND)
- Practice address
- 1876 Charleswood Estates Dr
West Fargo, ND 58078-4203 - Phone
- (701) 866-9934
- NPI assigned
- May 17, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120912000035 | ND | Practitioner - Qualified Speech Language Pathologist | 5698923910 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1212 | ND | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Myna Therapy Services PLLC | Speech-Language Pathologist | Current |
Accepting new patients |
| Big Stone Therapies Fargo, Inc | Current |
Accepting new patients | |
| Myna Early Intervention LLC | Past |
Accepting new patients | |
| Kennelly Speech Language Pathology LTD | Speech-Language Pathologist | Past |
Accepting new patients |
Locations
2401 41st St S
Fargo, ND 58104
Phone (701) 478-7868
4575 23rd Ave S
Ste 400
Fargo, ND 58104
Phone (701) 347-1782
645 33rd Ave E
West Fargo, ND 58078
Phone (701) 478-7868
500 Cross St
Big Stone Cty, SD 57216
Phone (605) 541-1140
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 1212 | ND | Yes |
Addresses
Primary practice location
1876 Charleswood Estates Dr
West Fargo, ND 58078-4203
Mailing address
1876 Charleswood Estates Dr
West Fargo, ND 58078-4203
Phone (701) 866-9934
Other providers in West Fargo, ND
- Christina Diede
- Renee Diekman
- Steven Michael Diekman
- Divine Allen'S Healthcare LLC
- David D Dobmeier
- Kingsley Dohnwana
- Audrey Dominguez
- Sanjuanita Dominguez
- Stacy Donahue
- Alfonso Mawotee Dormu
All providers in West Fargo, ND · Speech-Language Pathologist in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.