Individual provider Active NPI

Cassidy Mertz

  • Speech-Language Pathologist
  • Plymouth, MI
National Provider Identifier
1013520055
Registry record updated Aug 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
44670 Ann Arbor Rd W Ste 130
Plymouth, MI 48170-4085
Phone
(313) 278-4401
NPI assigned
Aug 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Primary

Addresses

Primary practice location

44670 Ann Arbor Rd W Ste 130
Plymouth, MI 48170-4085

Mailing address

44670 Ann Arbor Rd W Ste 130
Plymouth, MI 48170-4085

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210719002170 MI Practitioner - Qualified Speech Language Pathologist 6608279310 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Life Skills Village, PLLC CurrentSince Jun 30, 2025 Accepting new patients

Locations

25900 Greenfield Rd
Ste 10
Oak Park, MI 48237
Phone (248) 788-4300

25900 Greenfield Rd
Ste 100
Oak Park, MI 48237
Phone (248) 788-4300

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1013520055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44670 ANN ARBOR RD W STE 130",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44670 ANN ARBOR RD W STE 130",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704085",
            "telephone_number": "313-278-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERTZ",
        "first_name": "CASSIDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-28",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.