Hailey Nicol Valencour, OTD, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

9751 Regent Ave N
Brooklyn Park, MN 55443-1402

Phone

(763) 315-5340

NPI assigned

Jun 27, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ascend Rehab LLCGroup PAC ID 9032351192, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ascend Rehab, LLC

  • Physical Therapy Clinic/Center
  • St Louis Park, MN
  • NPI 1437403110
  Medicare reassignment Care Compare group NPD
• Saint Therese of Oxbow Lake, LLC

  • Skilled Nursing Facility
  • Brooklyn Park, MN
  • NPI 1619236767
  NPD (past)

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

{
    "created_epoch": "1719446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1619712940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 HIGHWAY 100 S STE 103",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161506",
            "telephone_number": "763-531-5039",
            "fax_number": "763-531-5004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9751 REGENT AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554431402",
            "telephone_number": "763-315-5340"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7555 Bailey Rd",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "MN",
            "postal_code": "551299610",
            "country_code": "US",
            "telephone_number": "651-209-9170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALENCOUR",
        "first_name": "HAILEY",
        "middle_name": "NICOL",
        "name_prefix": "Dr.",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-27",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Uplifted Community Services LLC
• Uplifting Praise Medical Transportation LLC
• V&P Medical Supply LLC
• Vaimar Suites LLC
• David Oswaldo Valdepena Garcia
• Valhalla Place, LLC
• Lisa Kay Vanberkel, PT
• Dennis J Vanden Berge, MD
• Lao Vang
• Michelle Vang, B.A

• Occupational Therapist in Brooklyn Park, MN
• Providers in Brooklyn Park, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.