Active NPI
Marisa Lynn Crooks, M.A., CCC-SLP
- Speech-Language Pathologist
- Orlando, FL
National Provider Identifier
1033436134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA10273
- Practice address
- 2125 Portlight Dr
201
Orlando, FL 32814-6951 - Phone
- (407) 435-5652
- NPI assigned
- Apr 28, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SA10273 | FL | Primary |
| Developmental Therapist | 222Q00000X | SA 10273 | FL |
Addresses
Primary practice location
2125 Portlight Dr
201
Orlando, FL 32814-6951
Mailing address
PO Box 2998
Winter Park, FL 32790-2998
Phone (407) 435-5652
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)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA 10273 | FL | MD | Developmental Therapist |
| SA10273 | FL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sandler Rehab Services, Inc. | Speech-Language Pathologist | Past | Accepting new patients |
| Speech Rehab Services LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Speech-Language Pathologist
- Boca Raton, FL
- NPI 1386881670
-
- Home Health Agency
- Boca Raton, FL
- NPI 1114268927
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310947200000",
"number": "1033436134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2998",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327902998",
"telephone_number": "407-435-5652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2125 PORTLIGHT DR",
"address_2": "201",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328146951",
"telephone_number": "407-435-5652"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROOKS",
"first_name": "MARISA",
"middle_name": "LYNN",
"credential": "M.A., CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-28",
"last_updated": "2011-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA10273",
"primary": true
},
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": "FL",
"license": "SA 10273",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.