Nicole Marie McGillicuddy

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

5530-154 Issued in WI

Practice address

2700 W Honadel Blvd
Oak Creek, WI 53154-2650

Phone

(414) 435-2005

NPI assigned

Jul 31, 2023

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1023799020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1888 N WATER ST APT 603",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532021569",
            "telephone_number": "630-272-8984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 W HONADEL BLVD",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531542650",
            "telephone_number": "414-435-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGILLICUDDY",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "5530-154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Masik
• Darcy Mason, LPC-IT, SAC-IT
• Ryan C McCann, DPT
• Sharlacia M McDougal
• Brian J McGee, PT
• Michael S McKinnis Jr., OT
• Eleanor McRae
• Meadowmere Oak Creek Management, LLC
• Meadowmere SLC Wi Tenant LLC
• Jamie Lynn Meece

• Speech-Language Pathologist in Oak Creek, WI
• Providers in Oak Creek, WI by specialty
• Speech-Language Pathologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.