Mary Sharyle Gagnepain, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

#SLPL0183 Issued in AZ

Practice address

8430 N 39TH Ave
Phoenix, AZ 85051-4778

Phone

(602) 347-2235

Fax

(602) 347-2220

NPI assigned

Mar 8, 2007

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mrs. Mickie Gagnepain Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1033240585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3109 N 46TH PL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850186535",
            "telephone_number": "602-347-2235",
            "fax_number": "602-347-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8430 N 39TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850514778",
            "telephone_number": "602-347-2235",
            "fax_number": "602-347-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNEPAIN",
        "first_name": "MARY",
        "middle_name": "SHARYLE",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "#SLPL0183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "558992",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICKIE",
            "last_name": "GAGNEPAIN",
            "prefix": "MRS.",
            "credential": "SLP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Karen Gage, PSY.D., LMFT
• Mally Gage, PHARMD, RPH
• Sandra L Gage, MD
• Ronald Anthony Gagliano Jr., M.D.
• Dominique Gagne, MD
• Charles E Gagnon, D.O.
• Cindy Bartlett Gagnon
• Erik Michael Gagnon
• Grace Gagnon
• Marie Lemay Gagnon, RN

• Speech-Language Pathologist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Speech-Language Pathologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.