Individual provider Active NPI

Cassandra Grace Hicks, MA

  • Speech-Language Pathologist
  • Boca Raton, FL
National Provider Identifier
1043817836
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SZ9543 Issued in FL
Practice address
5458 Town Center Rd Ste 1
Boca Raton, FL 33486-1026
Phone
(561) 376-2573
NPI assigned
Oct 5, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SZ9543 FL Primary

Addresses

Primary practice location

5458 Town Center Rd Ste 1
Boca Raton, FL 33486-1026

Mailing address

19754 Black Olive LN
Boca Raton, FL 33498-4854
Phone (386) 585-0240

Other practice location 1

3898 Via Poinciana Ste 17
Lake Worth, FL 33467-2951
Phone (561) 376-2573

Other practice location 2

2230E W Atlantic Ave
Delray Beach, FL 33445-4637
Phone (561) 376-2573

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.ppt4kids.com Progressive Pediatric Therapy, Inc.

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
SZ9543FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1043817836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19754 BLACK OLIVE LN",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334984854",
            "telephone_number": "386-585-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5458 TOWN CENTER RD STE 1",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334861026",
            "telephone_number": "561-376-2573"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3898 Via Poinciana Ste 17",
            "address_purpose": "LOCATION",
            "city": "Lake Worth",
            "state": "FL",
            "postal_code": "334672951",
            "country_code": "US",
            "telephone_number": "561-376-2573",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2230E W Atlantic Ave",
            "address_purpose": "LOCATION",
            "city": "Delray Beach",
            "state": "FL",
            "postal_code": "334454637",
            "country_code": "US",
            "telephone_number": "561-376-2573",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HICKS",
        "first_name": "CASSANDRA",
        "middle_name": "GRACE",
        "name_prefix": "Mrs.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-05",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ9543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.ppt4kids.com",
            "affiliation": "Y",
            "affiliationName": "Progressive Pediatric Therapy, Inc.",
            "address_1": "5458 Town Center Rd Ste 1",
            "city": "Boca Raton",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334861026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.