Active NPI
Terry Ann Sacks, MA CCC LSP
- Speech-Language Pathologist
- Bellingham, WA
National Provider Identifier
1093836355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- LL00003983
- Practice address
- 516 High St.
Bellingham, WA 98225-9078 - Phone
- (360) 650-3196
- Fax
- (360) 650-2843
- NPI assigned
- Apr 3, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | LL00003983 | WA | Primary |
Addresses
Primary practice location
516 High St.
Bellingham, WA 98225-9078
Mailing address
516 High St
Bellingham, WA 98225-9078
Phone (360) 650-3196
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0916000562-22 | Other | WA | DVR GROUP # |
| 7140007 | Medicaid | WA |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL00003983 | WA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western Washington University | Past | Accepting new patients | |
| Western Washington University Student Health Center | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Hearing and Speech Clinic/Center
- Bellingham, WA
- NPI 1215139605
-
- Student Health Clinic/Center
- Bellingham, WA
- NPI 1326262452
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1093836355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "516 HIGH ST",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982259078",
"telephone_number": "360-650-3196",
"fax_number": "360-650-2843"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "516 HIGH ST.",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982259078",
"telephone_number": "360-650-3196",
"fax_number": "360-650-2843"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SACKS",
"first_name": "TERRY",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "MA CCC LSP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-03",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WA",
"license": "LL00003983",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DVR GROUP #",
"identifier": "0916000562-22",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7140007",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bellingham, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.