Active NPI
Monica Phongsa, CCC-SLP
- Speech-Language Pathologist
- Danielson, CT
National Provider Identifier
1023720810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 77694
- Practice address
- 30 Melinda Ter
Danielson, CT 06239-1517 - Phone
- (860) 942-9619
- NPI assigned
- Dec 23, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 32745 | CA | |
| Speech-Language Pathologist | 235Z00000X | 4675 | CO | |
| Speech-Language Pathologist | 235Z00000X | 61339861 | WA | |
| Speech-Language Pathologist | 235Z00000X | 146028904 | SC | |
| Speech-Language Pathologist | 235Z00000X | 77694 | MA | Primary |
| Speech-Language Pathologist | 235Z00000X | 6165 | CT | |
| Speech-Language Pathologist | 235Z00000X | 208919 | AK |
Addresses
Primary practice location
30 Melinda Ter
Danielson, CT 06239-1517
Mailing address
30 Melinda Ter
Danielson, CT 06239-1517
Phone (860) 942-9619
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4675 | CO | MD | Chiropractor |
| 77694 | MA | MD | Neurology Physician |
| 32745 | CA | MD | Physical Therapist |
| 61339861 | WA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sea to Summit Speech Therapy LLC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Hearing and Speech Clinic/Center
- Danielson, CT
- NPI 1760390033
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1671753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785974400000",
"number": "1023720810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 MELINDA TER",
"city": "DANIELSON",
"state": "CT",
"postal_code": "062391517",
"telephone_number": "860-942-9619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 MELINDA TER",
"city": "DANIELSON",
"state": "CT",
"postal_code": "062391517",
"telephone_number": "860-942-9619"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHONGSA",
"first_name": "MONICA",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-12-23",
"last_updated": "2026-08-06",
"certification_date": "2026-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "32745",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CO",
"license": "4675",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WA",
"license": "61339861",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "SC",
"license": "146028904",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MA",
"license": "77694",
"primary": true
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CT",
"license": "6165",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AK",
"license": "208919",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Danielson, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.