Allison Henrickson, SLP
Individual provider Active NPI Speech-Language Pathologist · Grafton, ND
NPI 1376199810 · NPPES record last updated Aug 12, 2019
Key facts
- NPI
- 1376199810
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 1757 (ND)
- Practice address
- 1542 School Rd
Grafton, ND 58237-1715 - Phone
- (701) 352-1739
- NPI assigned
- Aug 12, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200811001448 | MN | Practitioner - Qualified Speech Language Pathologist | 6406271295 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1757 | ND | MD | Addiction (Substance Use Disorder) Counselor |
| 10278 | MN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Health Network North | Current |
Accepting new patients | |
| Sanford Health Network North | Current | Accepting new patients | |
| Sanford Health Network North | Current |
Accepting new patients | |
| Sanford Health Network North | Past | Accepting new patients | |
| Upper Valley Special Education | Speech-Language Pathologist | Past |
Accepting new patients |
Locations
120 Labree Ave S
Thief Rvr Fls, MN 56701
Phone (218) 681-0600
1720 US Highway 59 SE
Thief Rvr Fls, MN 56701
Phone (218) 681-4747
3001 Sanford Pkwy
Thief Rvr Fls, MN 56701
Phone (218) 681-4240
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 1757 | ND | Yes |
Addresses
Primary practice location
1542 School Rd
Grafton, ND 58237-1715
Mailing address
516 Cooper Ave Ste 102
Grafton, ND 58237-1512
Phone (701) 352-2574
Other providers in Grafton, ND
- Sara Gusaas
- Abdul Hafeez
- Pamela Jean Hagen
- Heartland Eye Care, P.C.
- Sharon Ann Hedlund
- Claudia Ivet Hernandez
- Cynthia J Hiltner
- Katerina M Hoime
- Kelly Jo Houska
- Shawnya Jacobson
All providers in Grafton, 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 Aug 12, 2019. 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.