Devon Amanda Idalski, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7101005109 Issued in MI

Practice address

109 N 2ND Ave Ste 203
Alpena, MI 49707-5305

Phone

(989) 278-8747

Fax

(989) 331-6705

NPI assigned

May 10, 2016

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

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.

• Channels Rehabilitation LLC

  • Rehabilitation Clinic/Center
  • Alpena, MI
  • NPI 1235883711
  NPD Authorized official

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

{
    "created_epoch": "1462838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1043666993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16461 PINE ST",
            "city": "PRESQUE ISLE",
            "state": "MI",
            "postal_code": "497778653",
            "telephone_number": "810-305-0627",
            "fax_number": "989-331-6705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 N 2ND AVE STE 203",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "497075305",
            "telephone_number": "989-278-8747",
            "fax_number": "989-331-6705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDALSKI",
        "first_name": "DEVON",
        "middle_name": "AMANDA",
        "name_prefix": "Ms.",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-10",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101005109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "7101005109",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "devon@channelsrehab.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "109 N 2nd Ave Ste 203",
            "city": "Alpena",
            "state": "MI",
            "country_code": "US",
            "postal_code": "497075305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Katherine Hughey Lucas
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• Lucinda Epifania Huron-Hernandez
• Ledonna R Husband
• In Harmony Professional Counseling Services PLLC
• Indigo Hospital Medicine - Alpena, PLC
• Integrated Family Care, PC
• Internal Medicine Clinic PLLC
• Catherine A Isbell, LMSW

• Speech-Language Pathologist in Alpena, MI
• Providers in Alpena, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; 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.