Jessica Jeanne Smith, MA, CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Bel Aire, KS

NPI 1013328707 · NPPES record last updated Nov 25, 2020

Key facts

NPI
1013328707
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
3792 (KS)
Practice address
4561 Westlake CT.
Bel Aire, KS 67220
Phone
(316) 304-5303
Fax
(316) 634-8850
NPI assigned
May 15, 2014
Sex
Female
Sole proprietor
Yes

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
3792KSMDSpeech-Language Pathologist
K01754066KSMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Crafty Speech Therapy, LLC Speech-Language Pathologist Current
since Dec 6, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X K01754066 KS
Speech-Language Pathologist 235Z00000X 3792 KS Yes

Addresses

Primary practice location

4561 Westlake CT.
Bel Aire, KS 67220

Mailing address

4561 Westlake CT.
Bel Aire, KS 67220
Phone (316) 304-5303

Other names

  • Jessica Jeanne Mirt Former name

Other providers in Bel Aire, KS

All providers in Bel Aire, KS · Speech-Language Pathologist in Kansas

Sources for this page

Verify at the official NPI Registry.