Elizabeth Marie Deacon

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

518109 Issued in MN

Practice address

3395 Plymouth Rd
Minnetonka, MN 55305-3765

Phone

(952) 939-0396

NPI assigned

May 26, 2021

Last updated

May 26, 2021By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1621987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1063087401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16326 FERNANDO WAY W",
            "city": "ROSEMOUNT",
            "state": "MN",
            "postal_code": "550681469",
            "telephone_number": "920-615-4140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3395 PLYMOUTH RD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553053765",
            "telephone_number": "952-939-0396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEACON",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-26",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "518109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosmarie Dauth, LICSW, LADC
• Chelseanne Luella Davidson
• Cassandra Head Davis, FNP
• Tamara Davis, NP
• Lorena C De la Rosa, FNP-C
• Megan Mosley Deal, MSN, FNP-BC
• Christopher Daryl Dean, D.C
• Lauren Dean, NP
• Deborah Coen M.D. Psychiatric Services L.L.C.
• Kevin P Dee

• Speech-Language Pathologist in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Speech-Language Pathologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; 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.