Emily Irene Poliseo, MA CCC SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

12136614 Issued in CO

Practice address

4812 E Kentucky Ave
Unit F
Glendale, CO 80246-2201

Phone

(720) 318-4615

NPI assigned

Feb 26, 2008

Last updated

Feb 26, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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.

• Proactive Pediatrics, LLC

  • Speech-Language Pathologist
  • Denver, CO
  • NPI 1346639507
  Authorized official Same address or phone

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

{
    "created_epoch": "1203984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203984000000",
    "number": "1073782876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4812 EAST KENTUCKY AVENUE",
            "address_2": "UNIT F",
            "city": "GLENDALE",
            "state": "CO",
            "postal_code": "80246",
            "telephone_number": "720-318-4615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4812 E KENTUCKY AVE",
            "address_2": "UNIT F",
            "city": "GLENDALE",
            "state": "CO",
            "postal_code": "802462201",
            "telephone_number": "720-318-4615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLISEO",
        "first_name": "EMILY",
        "middle_name": "IRENE",
        "credential": "MA CCC SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-26",
        "last_updated": "2008-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "12136614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "96606223",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paige Ozegovic, MHS., CCC-SLP
• Vanessa Marie Padilla, MA, LPC
• Jeffrey Kevin Parker, MA, NCC
• Brandon John Perticone, PHARMD
• Deanne Lynn Phillips, CFPNP
• Judy Pomerantz, PSY D
• Audrey-Carmel Porter, PHARMD
• Portercare Adventist Health System (South Denver Cardiology Cherry Creek)
• Portercare Adventist Health System (AdventHealth Medical Group Family Medicine at Cherry Creek)
• Sophia Postma, PHARMD

• Speech-Language Pathologist in Glendale, CO
• Providers in Glendale, CO by specialty
• Speech-Language Pathologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; 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.