KELSEY JEAN VAN VICKLE (NPI# 1316313091) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316313091 |
| Entity Type | Individual |
| Full Name | KELSEY JEAN VAN VICKLE |
| Practice Address |
1935 County Road B2 W Ste 100 Roseville MN 55113-2722 |
| Mailing Address |
1947 Stinson Blvd Minneapolis MN 55418-4820 |
| Practice Telephone | 6516364155 |
| Practice Fax Number | 6516363595 |
| Mailing Telephone | 6122294087 |
| Enumeration Date | 2015-08-17 |
| Last Update Date | 2015-08-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | 9542 | MN | Speech, Language and Hearing Service Providers |
| Street Address |
1935 COUNTY ROAD B2 W STE 100 |
| City | ROSEVILLE |
| State | MN |
| Zip Code | 55113-2722 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972162154 | Emily Kollodge | Occupational Therapist | 1935 County Road B2 W Ste 100, Roseville, MN 55113-2722 | 2019-06-11 |
| 1407333461 | Ruth Carol Anderson-benge | Speech-Language Pathologist | 1935 County Road B2 W Ste 100, Roseville, MN 55113-2722 | 2018-07-23 |
| 1316457989 | Jessika Mae Viola Lackie | Occupational Therapist | 1935 County Road B2 W Ste 100, Roseville, MN 55113-2722 | 2017-10-09 |
| 1841728581 | Kathleen Wagner | Speech-Language Pathologist | 1935 County Road B2 W Ste 100, Roseville, MN 55113-2722 | 2017-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396384376 | Zachary Mattson | Physician Assistant | Regus Coworking Space 2355 Highway 36 West, Suite 400, Office #427, Roseville, MN 55113 | 2019-12-23 |
| 1467010330 | Ahmed Issa | Student in an Organized Health Care Education/Training Program | 1550 Larpenteur Ave W, Apt 235, St Paul, MN 55113 | 2019-06-05 |
| 1821653833 | Suite Living Senior Care of Little Canada | Assisted Living Facility | 2740 Rice Street, Little Canada, MN 55113 | 2019-05-06 |
| 1902370505 | Diverse Assessments and Treatment, LLC | Psychologist | 1935 Cty Rd B2 W Ste 270, Roseville, MN 55113 | 2019-01-16 |
| 1588138473 | Applewood Home Health Care, LLC | Home Health | 2021 E Hennepin Avenue # 402-1, Minneapolis, MN 55113 | 2019-01-14 |
| 1699251520 | Optum Infusion Services 500, Inc. | Durable Medical Equipment & Medical Supplies | 2685 Patton Rd, Roseville, MN 55113 | 2018-07-13 |
| 1083104145 | Suite Living Senior Care of Roseville | Assisted Living Facility | 197 County Road B2 W, Roseville, MN 55113 | 2018-05-15 |
| 1477055796 | Sunrise Residential Services LLC | Home Health | 216 Maple Ln, Roseville, MN 55113 | 2018-03-02 |
| 1194223024 | Alissa Hoff | Specialist | 1595 Mn 36 - 584 10 Rosedale Center, Roseville, MN 55113 | 2018-01-25 |
| 1841705118 | Kingsland Care Services Incorporated | Case Management | 2301 Rice Street, Suite 101, Roseville, MN 55113 | 2017-12-08 |
| Find all providers in zip 55113 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518424720 | Jacquelyn R Rampenelli | Speech-Language Pathologist | 1056 Impressionist Loop, Roseville, CA 95747-5170 | 2019-02-24 |
| 1700370772 | Rebecca Larussa | Speech-Language Pathologist | 532 Gibson Dr Ste 100, Roseville, CA 95678-5878 | 2018-06-21 |
| 1386146231 | Mallori Schneider | Speech-Language Pathologist | 2941 Northview St, Roseville, MN 55113-2438 | 2018-03-07 |
| 1457876211 | Charlotte Elizabeth Pegoda | Speech-Language Pathologist | 5051 Dragonfly Ln, Roseville, CA 95747-8616 | 2017-08-13 |
| 1649729229 | Isabelle Stoffel | Speech-Language Pathologist | 570 Sandhurst Dr W, Apartment 317, Roseville, MN 55113-4699 | 2016-09-24 |
| 1053764969 | Mary Coutts | Speech-Language Pathologist | 1560 Snapdragon Ln, Roseville, CA 95747-7518 | 2016-07-15 |
| 1427427772 | Patricia Graves | Speech-Language Pathologist | 1872 Eagle Glen Dr, Roseville, CA 95661-4025 | 2015-09-16 |
| 1740668086 | Mini Nandakumar | Speech-Language Pathologist | 1320 Impressionist Loop, Roseville, CA 95747-5171 | 2015-05-06 |
| 1780082412 | Jeanne Ann Smith | Speech-Language Pathologist | 6550 Rose Hill Rd, Roseville, OH 43777-9741 | 2014-12-11 |
| 1710389077 | Brittni Zimmerman | Speech-Language Pathologist | 271 68th St, Roseville, IL 61473-9395 | 2014-09-18 |
| Find all providers in ROSEVILLE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.