Rachael Kathleen McLean – Speech-Language Pathologist

Key facts

NPI: 1093202152
Entity type: Individual (NPI type 1)
Primary specialty: Speech-Language Pathologist 235Z00000X
License: 4947 (OK)
Practice address: 1040 SW 4TH St
Moore, OK 73160-2405
Phone: (405) 735-6333
Fax: (405) 735-6629
NPI assigned: Apr 15, 2018
Sex: Female
Sole proprietor: No

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 and National Provider Directory roles.

Moore Autism Center, P.C. Clinical Child & Adolescent Psychologist · Moore, OK · NPI 1518319276

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Master of Science

State licenses

License	State	Type	Specialty
4947	OK	MD	Pediatric Physical Therapist

Practice roles

Organization	Specialty	Status	New patients
Moore Autism Center, P.C.		Past since Apr 1, 2020	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Speech-Language Pathologist	235Z00000X	4947	OK	Yes

Addresses

Primary practice location

1040 SW 4TH St
Moore, OK 73160-2405

Mailing address

1040 SW 4TH St
Moore, OK 73160-2405
Phone (405) 735-6333

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 15, 2018.

{
    "created_epoch": "1523750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523750400000",
    "number": "1093202152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 SW 4TH ST",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731602405",
            "telephone_number": "405-735-6333",
            "fax_number": "405-735-6629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 SW 4TH ST",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731602405",
            "telephone_number": "405-735-6333",
            "fax_number": "405-735-6629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEAN",
        "first_name": "RACHAEL",
        "middle_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-15",
        "last_updated": "2018-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "4947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moore, OK

All providers in Moore, OK · Speech-Language Pathologist in Oklahoma

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 15, 2018. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.