Individual provider Active NPI

Stacy Levang, CCC-SLP

  • Speech-Language Pathologist
  • Moorhead, MN
National Provider Identifier
1538561253
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
395299 Issued in MN
Practice address
1313 30TH Ave S
Moorhead, MN 56560-5106
Phone
(218) 284-3713
NPI assigned
Sep 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 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 395299 MN Primary

Addresses

Primary practice location

1313 30TH Ave S
Moorhead, MN 56560-5106

Mailing address

1313 30TH Ave S
Moorhead, MN 56560-5106
Phone (218) 284-3713

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
9348MNMDDentist
1383NDMDPhysical Therapist
395299MNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Beyond Boundaries Occupational Therapy, Inc. Speech-Language Pathologist PastSince Jul 1, 2009 Accepting new patients

Organizations & group practices 1

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": "1411516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777593600000",
    "number": "1538561253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 30TH AVE S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565605106",
            "telephone_number": "218-284-3713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 30TH AVE S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565605106",
            "telephone_number": "218-284-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVANG",
        "first_name": "STACY",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-24",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "395299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorhead, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2026; 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.