Gulf Coast Speech Language Services, PLLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

GULF COAST SPEECH LANGUAGE SERVICES, PLLC

Practice address

5972 Dahoon Dr
Pensacola, FL 32526-3246

Phone

(850) 380-4063

NPI assigned

Aug 1, 2020

Last updated

Nov 30, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mildred Zusselly McIlwain, M.S. CCC-SLPNPI 1346571155

Title

Speech Language Pathologist

Phone

(850) 696-7583

Specialties & licenses 1

Addresses

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mildred Zusselly McIlwain, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Pensacola, FL
  • NPI 1346571155

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1596240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606694400000",
    "number": "1043820368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5972 DAHOON DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325263246",
            "telephone_number": "850-696-7583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5972 DAHOON DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325263246",
            "telephone_number": "850-380-4063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST SPEECH LANGUAGE SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-01",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A",
        "authorized_official_last_name": "MCILWAIN",
        "authorized_official_first_name": "MILDRED",
        "authorized_official_middle_name": "ZUSSELLY",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "850-696-7583",
        "authorized_official_credential": "M.S. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smcilwain@gulfcoastspeech.com",
            "affiliation": "N",
            "endpointDescription": "business email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5972 Dahoon Dr",
            "city": "Pensacola",
            "state": "FL",
            "country_code": "US",
            "postal_code": "325263246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Speech-Language Pathologist in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; 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.