Individual provider Active NPI

Cherice Lynn Wyckoff, SLP

  • Speech-Language Pathologist
  • Midlothian, TX
National Provider Identifier
1104312115
Registry record updated Jul 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
111715 Issued in TX
Practice address
848 Nueces TRL
Midlothian, TX 76065-5555
Phone
(817) 789-3292
NPI assigned
Jul 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2018

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 111715 TX Primary

Addresses

Primary practice location

848 Nueces TRL
Midlothian, TX 76065-5555

Mailing address

848 Nueces TRL
Midlothian, TX 76065-5555
Phone (817) 789-3292

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
111715TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1104312115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "848 NUECES TRL",
            "city": "MIDLOTHIAN",
            "state": "TX",
            "postal_code": "760655555",
            "telephone_number": "817-789-3292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "848 NUECES TRL",
            "city": "MIDLOTHIAN",
            "state": "TX",
            "postal_code": "760655555",
            "telephone_number": "817-789-3292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYCKOFF",
        "first_name": "CHERICE",
        "middle_name": "LYNN",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-03",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "111715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2018; 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.