Individual provider Active NPI

Dana Lynn Hayes, MA CCC-SLP

  • Speech-Language Pathologist
  • St Louis Park, MN
National Provider Identifier
1649094228
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
529009 Issued in MN
Practice address
4645 Park Commons Dr Apt 503
St Louis Park, MN 55416-4173
Phone
(612) 240-4699
NPI assigned
Nov 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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 529009 MN Primary

Addresses

Primary practice location

4645 Park Commons Dr Apt 503
St Louis Park, MN 55416-4173

Mailing address

5115 Excelsior Blvd Ste 720
St Louis Park, MN 55416-2906
Phone (612) 352-9905

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)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
529009MNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Creating Soulcial Connections LLC Speech-Language Pathologist CurrentSince Nov 17, 2024 Accepting new patients

Locations

5115 Excelsior Blvd
St Louis Park, MN 55416
Phone (763) 753-2807

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": "1731283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1649094228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5115 EXCELSIOR BLVD STE 720",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162906",
            "telephone_number": "612-352-9905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4645 PARK COMMONS DR APT 503",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164173",
            "telephone_number": "612-240-4699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYES",
        "first_name": "DANA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-11",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "529009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; 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.