| Minnesota State Colleges & Universities | |
|
1104 7th Ave South, Msum Box 119, Moorhead, MN 56563-0001 | |
| (218) 477-2330 | |
| (218) 477-2330 |
| Full Name | Minnesota State Colleges & Universities |
|---|---|
| Type | Facility |
| Speciality | Speech-language Pathologist |
| Location | 1104 7th Ave South, Moorhead, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215000963 | NPI | - | NPPES |
| 51661 | Medicaid | ND | |
| 7G917MO | Other | MN | MN BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | (* (Not Available)) | Primary |
| Provider Name | Mary K Drake |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1346332947 PECOS PAC ID: 0143458109 Enrollment ID: I20140121000803 |
| Provider Name | Nancy A Paul |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1184716771 PECOS PAC ID: 8820226806 Enrollment ID: I20140121001093 |
| Provider Name | Joni K Mehrhoff |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1891906202 PECOS PAC ID: 0244450674 Enrollment ID: I20141006001905 |
| Provider Name | Jill M Beuckens |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1376929513 PECOS PAC ID: 8224344692 Enrollment ID: I20150831001477 |
| Provider Name | Lowell Buysse |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1083066252 PECOS PAC ID: 0143565200 Enrollment ID: I20181218000467 |
| Provider Name | Sarah J Ring |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1083018790 PECOS PAC ID: 6103164769 Enrollment ID: I20190207000038 |
| Provider Name | Jasmine N Nelson |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1528597507 PECOS PAC ID: 4183979453 Enrollment ID: I20201110002076 |
| Provider Name | William E Strong |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1457588261 PECOS PAC ID: 1951716588 Enrollment ID: I20210212000707 |
| Provider Name | Kristin E Berndt |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1073933248 PECOS PAC ID: 9335556737 Enrollment ID: I20210401000064 |
| Provider Name | Elizabeth G Wychor |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1497148472 PECOS PAC ID: 1850610056 Enrollment ID: I20210520001051 |
| Provider Name | Jennifer L Wollan |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1861690752 PECOS PAC ID: 4789072174 Enrollment ID: I20211104001738 |
| Provider Name | Whitney H Mead |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1538546551 PECOS PAC ID: 5496069049 Enrollment ID: I20220906002969 |
| Provider Name | Tinotenda Chiedza Mupambo |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1851085658 PECOS PAC ID: 4082069703 Enrollment ID: I20231016000670 |
| Provider Name | Leah Carpenter |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1891533378 PECOS PAC ID: 0345781225 Enrollment ID: I20240918003802 |
| Provider Name | Logan M Winter |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1780360115 PECOS PAC ID: 5092246900 Enrollment ID: I20241002003864 |
| Mailing Address | Practice Location Address |
|---|---|
| Minnesota State Colleges & Universities 1104 7th Ave South, Msum Box 119, Moorhead, MN 56563-0001 Ph: (218) 477-2330 | Minnesota State Colleges & Universities 1104 7th Ave South, Msum Box 119, Moorhead, MN 56563-0001 Ph: (218) 477-2330 |
Vicki L Riedinger, MS CCC SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1104 7th Ave South, Msum Box 119, Moorhead, MN 56563 Phone: 218-477-4627 Fax: 218-477-4392 | |
Larae A Mcgillivray, MS CCCSLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1104 7th Ave S, Msum Box 119, Moorhead, MN 56563 Phone: 218-477-4639 Fax: 218-477-4392 | |
Louis J Demaio, PHD CCCSLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1104 7th Ave South, Msum Box 119, Moorhead, MN 56563 Phone: 218-477-4643 Fax: 218-477-4392 | |
Bruce R Hanson, MS CCC SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1104 7th Ave South, Msum Box 119, Moorhead, MN 56563 Phone: 218-477-4641 Fax: 218-477-4392 | |
Mr. Lowell Matthew Buysse, M.S., CCC-SLP Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 1104 7th Ave South, Murray Hall, Moorhead, MN 56563 Phone: 218-477-2330 Fax: 218-477-4392 | |
Marie E Swanson, MS CCC SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1104 7th Ave South, Msum Box 119, Moorhead, MN 56563 Phone: 218-477-5841 Fax: 218-477-4392 | |
Stephanie Kay Holm, SLP-CCC-MS Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1104 7th Ave S, Moorhead, MN 56563 Phone: 218-477-2330 |