Whitney Cordova, M.S. CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Clovis, NM
NPI 1023534112 · NPPES record last updated Oct 2, 2020
Key facts
- NPI
- 1023534112
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SLP7071 (NM)
- Practice address
- 1600 Sutter PL
Clovis, NM 88101-4611 - Phone
- (575) 749-4490
- NPI assigned
- Aug 21, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP7071 | NM | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eastern New Mexico University | Speech-Language Pathologist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Speech-Language Pathologist | 235Z00000X | SLP7071 | NM | Yes |
Addresses
Primary practice location
1600 Sutter PL
Clovis, NM 88101-4611
Mailing address
PO Box 19000
Clovis, NM 88102-9000
Other practice location 1
1500 S Ave K
Station 3, SHROC
Portales, NM 88130
Phone (575) 562-2160
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023534112 | Medicaid | NM |
Other providers in Clovis, NM
- Christy Cooper
- Herson Corcio
- Angela V. Cordova
- Claudia R. Cordova
- Maliah Cordova
- Jared Cordum
- Cornerstone Caregiving West LLC
- Nicole R Coronado
- Keishla Cota
- Clarence Edward Cotton Jr.
All providers in Clovis, NM · Speech-Language Pathologist in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 2, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.