ADVANCE SPEECH THERAPY LLC NPI 1215144654

NPI Information

NPI: 1215144654
Provider Name: ADVANCE SPEECH THERAPY, LLC
Classification: Speech-Language Pathologist - 235Z00000X
Entity Type: Organization
Doing Business As: ADVANCE THERAPY
Address: 6776 LAKE DR
220
LINO LAKES, MN
ZIP 55014
Phone: (651) 784-7007

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NPI Details

ADVANCE SPEECH THERAPY, LLC is a speech language pathologist in Lino Lakes, MN. The provider is 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. ADVANCE SPEECH THERAPY, LLC NPI is 1215144654. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Advance Therapy.

The provider's business location address is:

6776 LAKE DR
220
LINO LAKES, MN
ZIP 55014
Phone: (651) 784-7007
Fax: (651) 784-7992

The provider's authorized official is Jennifer M Jensen .
The authorized official title is Owner and has the following contact phone number (651) 784-7007.

The enumeration date for this NPI number is 5/16/2007 and was last updated on 7/2/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	License Number	License State	Primary
1	235Z00000X	Speech-Language Pathologist	8361	MINNESOTA	No
2	235Z00000X	Speech-Language Pathologist	8679	MINNESOTA	No
3	235Z00000X	Speech-Language Pathologist	8826	MINNESOTA	No
4	235Z00000X	Speech-Language Pathologist	8490	MINNESOTA	No
5	235Z00000X	Speech-Language Pathologist	7350	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	073222200	MEDICAID	MINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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