Individual provider Active NPI

Audrey Haugen

  • Speech-Language Pathologist
  • Fargo, ND
National Provider Identifier
1124911490
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2864 Issued in ND
Practice address
3244 51St St S
Fargo, ND 58104-7179
Phone
(701) 356-0062
NPI assigned
Jun 3, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2864 ND Primary

Addresses

Primary practice location

3244 51St St S
Fargo, ND 58104-7179

Mailing address

3244 51St St S
Fargo, ND 58104-7179

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250703001573 ND Practitioner - Qualified Speech Language Pathologist 8123531902 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beyond Boundaries Speech Language Therapy, IncGroup PAC ID 7315119989, 8 clinicians

Practice addresses (Care Compare)

3244 51St St S
Fargo, ND 58104-7179
Phone (701) 356-0062

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2864NDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Beyond Boundaries Occupational Therapy, Inc. Speech-Language Pathologist CurrentSince Oct 1, 2025 Accepting new patients
Beyond Boundaries Speech Language Therapy, Inc. Speech-Language Pathologist CurrentSince Jul 7, 2025 Accepting new patients
Kennelly Speech Language Pathology LTD Speech-Language Pathologist CurrentSince Jul 7, 2025 Accepting new patients

Locations

4450 31st Ave S
Ste 103
Fargo, ND 58104
Phone (701) 364-5433

3244 51st St S
Fargo, ND 58104
Phone (701) 356-0062

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1748908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1124911490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3244 51ST ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3244 51ST ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047179",
            "telephone_number": "701-356-0062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUGEN",
        "first_name": "AUDREY",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-06-03",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "2864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.