Individual provider Active NPI

Darriean Jade Langlie

  • Speech-Language Pathologist
  • Fargo, ND
National Provider Identifier
1689167678
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1647 Issued in ND
Practice address
4500 36TH Ave S Ste 200
Fargo, ND 58104-5275
Phone
(701) 532-1507
NPI assigned
Jun 13, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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 1647 ND Primary

Addresses

Primary practice location

4500 36TH Ave S Ste 200
Fargo, ND 58104-5275

Mailing address

4152 30TH Ave S
Fargo, ND 58104-8524

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190624003209 ND Practitioner - Qualified Speech Language Pathologist 8022342153 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1647NDMDAddiction (Substance Use Disorder) Counselor
10181MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
On Spot Therapy and Orofacial Myology, LLC Speech-Language Pathologist CurrentSince Oct 18, 2023 Accepting new patients
Anne Carlsen Center for Children PastSince Dec 16, 2020 Accepting new patients

Locations

4500 36th Ave S
Ste 200
Fargo, ND 58104
Phone (701) 532-1507

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1689167678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4152 30TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 36TH AVE S STE 200",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581045275",
            "telephone_number": "701-532-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGLIE",
        "first_name": "DARRIEAN",
        "middle_name": "JADE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-13",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "1647",
            "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 Jul 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.