Individual provider Active NPI

Jacqueline Serletti

  • Speech-Language Pathologist
  • Jacksonville, FL
National Provider Identifier
1013540129
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA17231 Issued in FL
Practice address
6817 Southpoint Pkwy Ste 1602
Jacksonville, FL 32216-6298
Phone
(919) 247-2450
Fax
(904) 379-0113
NPI assigned
Feb 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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 SA17231 FL Primary

Addresses

Primary practice location

6817 Southpoint Pkwy Ste 1602
Jacksonville, FL 32216-6298

Mailing address

1644 Summerdown Way
Jacksonville, FL 32259-6241
Phone (678) 371-2812

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SA17231FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapeutic Speech and Language Services Inc. Speech-Language Pathologist Past Accepting new patients

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": "1581897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1013540129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1644 SUMMERDOWN WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322596241",
            "telephone_number": "678-371-2812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6817 SOUTHPOINT PKWY STE 1602",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166298",
            "telephone_number": "919-247-2450",
            "fax_number": "904-379-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERLETTI",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-17",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA17231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.