Individual provider Active NPI

Stephanie Kolach, MA, CCC-SLP

  • Speech-Language Pathologist
  • Springfield, OH
National Provider Identifier
1053718122
Registry record updated Dec 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
11364 Issued in OH
Practice address
3640 E High St
Springfield, OH 45505-1645
Phone
(937) 328-5380
NPI assigned
Dec 4, 2014
Last updated
Dec 4, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2014

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 11364 OH Primary

Addresses

Primary practice location

3640 E High St
Springfield, OH 45505-1645

Mailing address

3680 Selma Rd
Springfield, OH 45502-6310
Phone (937) 328-5378

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
11364OHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Clark-Shawnee Local Schools Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1417651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417651200000",
    "number": "1053718122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3680 SELMA RD",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455026310",
            "telephone_number": "937-328-5378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3640 E HIGH ST",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455051645",
            "telephone_number": "937-328-5380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLACH",
        "first_name": "STEPHANIE",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-04",
        "last_updated": "2014-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "11364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2014; 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.