Individual provider Active NPI

Abbey Wicklund, CCC-SLP

  • Speech-Language Pathologist
  • Northglenn, CO
National Provider Identifier
1093586497
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
14485443 Issued in CO
Practice address
10701 Melody Dr Ste 100
Northglenn, CO 80234-4130
Phone
(720) 872-6472
NPI assigned
Jan 15, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2024

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 14485443 CO Primary

Addresses

Primary practice location

10701 Melody Dr Ste 100
Northglenn, CO 80234-4130

Mailing address

2820 Champa St
Denver, CO 80205-2745

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

State licenses

LicenseStateTypeSpecialty
14485443COMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Therapy Services of Colorado, Inc. Speech-Language Pathologist CurrentSince May 19, 2024 Accepting new patients

Locations

10701 Melody Dr
Ste 100
Northglenn, CO 80234
Phone (720) 212-8156

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.

NPI Registry JSON

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

{
    "created_epoch": "1705276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1093586497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 CHAMPA ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802052745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10701 MELODY DR STE 100",
            "city": "NORTHGLENN",
            "state": "CO",
            "postal_code": "802344130",
            "telephone_number": "720-872-6472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKLUND",
        "first_name": "ABBEY",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-15",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "14485443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northglenn, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.