NPIMap

Organization Active NPI

Sundance Kids Speech and Language Therapy PLLC

  • Speech-Language Pathologist
  • Fuquay Varina, NC
National Provider Identifier
1053736512
Registry record updated Feb 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
10184 Issued in NC
Legal business name
SUNDANCE KIDS SPEECH AND LANGUAGE THERAPY PLLC
Practice address
2033 Herbert Akins Rd
Fuquay Varina, NC 27526-8300
Phone
(919) 577-6135
NPI assigned
Feb 20, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2014

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

Authorized official

Name
Andrea Diane Behrns-Miller, M.A. CCC-SLP
Title
Owner
Phone
(919) 577-6135

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 10184 NC Primary

Addresses

Primary practice location

2033 Herbert Akins Rd
Fuquay Varina, NC 27526-8300

Mailing address

2033 Herbert Akins Rd
Fuquay Varina, NC 27526-8300
Phone (919) 577-6135

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1392854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392854400000",
    "number": "1053736512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2033 HERBERT AKINS RD",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275268300",
            "telephone_number": "919-577-6135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2033 HERBERT AKINS RD",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275268300",
            "telephone_number": "919-577-6135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNDANCE KIDS SPEECH AND LANGUAGE THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-20",
        "last_updated": "2014-02-20",
        "status": "A",
        "authorized_official_last_name": "BEHRNS-MILLER",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-577-6135",
        "authorized_official_credential": "M.A. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "10184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fuquay Varina, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.