Haley Theodosis, MA,CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

016238 Issued in OR

Practice address

1475 Capitol St NE
Salem, OR 97301-7850

Phone

(971) 599-1712

NPI assigned

May 16, 2018

Last updated

May 16, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sensible Speech-Language Pathology, IncGroup PAC ID 7012279433, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sensible Speech-Language Pathology, Inc

  • Speech-Language Pathologist
  • Salem, OR
  • NPI 1144645102
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1526428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526428800000",
    "number": "1023508835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 CAPITOL ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973017850",
            "telephone_number": "971-599-1712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 CAPITOL ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973017850",
            "telephone_number": "971-599-1712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEODOSIS",
        "first_name": "HALEY",
        "name_prefix": "Ms.",
        "credential": "MA,CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-16",
        "last_updated": "2018-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "016238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Recovery Village Oregon, LLC (The Recovery Village Salem Drug, Alcohol and Mental Health Rehab)
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• The Trauma Academy Northwest, LLC
• The Williamstopher Care LLC
• Lisa Dawn Theobald, PMHNP
• Therapeutic Associates Inc (TAI Valley Physical Therapy South)
• Therapeutic Associates Inc (TAI - SE Salem)
• Therapeutic Associates Inc (TAI Valley Physical Therapy North)
• Therapeutic Associates, Inc (TAI - Valley Physical Therapy West Salem)
• Theresa Peters Counseling LLC

• Speech-Language Pathologist in Salem, OR
• Providers in Salem, OR by specialty
• Speech-Language Pathologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.