Grace Levasseur, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

0002429 Issued in CO

Practice address

611 Korte Parkway
Longmont, CO 80501

Phone

(303) 776-1373

NPI assigned

May 26, 2016

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 names 1

• Grace Kloberdanz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• The Tiny Tim Center, Inc.

  • Clinic/Center
  • Longmont, CO
  • NPI 1568519320

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1464220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464220800000",
    "number": "1104274539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6699 SAVVY PL",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805248828",
            "telephone_number": "970-396-4083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 KORTE PARKWAY",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "80501",
            "telephone_number": "303-776-1373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVASSEUR",
        "first_name": "GRACE",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-26",
        "last_updated": "2016-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "0002429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRACE",
            "last_name": "KLOBERDANZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Derek G Leopold, MD
• Mark G Lersch, LPC
• Kristen Marie Lervik, PA-C
• Laurel Rae Leslie-Martin, D.D.S., M.S.
• Zachery Lesniak, D.C
• David Leverett, OD
• Allyson Levin, LMT
• Ruth Gene Levin
• Allison R Levine, PHD
• Diane Levine, WHNP-BC

• Speech-Language Pathologist in Longmont, CO
• Providers in Longmont, 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 May 26, 2016; 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.