NPIMap

Nicole Renee Dawson, MA, CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Conifer, CO

NPI 1003183385 · NPPES record last updated Nov 30, 2011

Key facts

NPI
1003183385
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
12039184 (CO)
Practice address
10846 Elder Ave.
Conifer, CO 80433
Phone
(720) 851-4820
NPI assigned
Nov 30, 2011
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
12039184COMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Small Talk Therapy, Inc. Speech-Language Pathologist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 12039184 CO Yes

Addresses

Primary practice location

10846 Elder Ave.
Conifer, CO 80433

Mailing address

10846 Elder Ave.
Conifer, CO 80433
Phone (720) 851-4820

Other providers in Conifer, CO

All providers in Conifer, CO · Speech-Language Pathologist in Colorado

Sources for this page

Verify at the official NPI Registry.