Jacquelyn S Dewaal, M.A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7101006797 Issued in MI

Practice address

1096 34TH St
Allegan, MI 49010-9305

Phone

(269) 365-3279

Fax

(269) 781-9290

NPI assigned

Sep 3, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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.

• Communication Haven, LLC

  • Hearing and Speech Clinic/Center
  • Allegan, MI
  • NPI 1356088801
  NPD Authorized official

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

{
    "created_epoch": "1567468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1104474089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1096 34TH ST",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490109305",
            "telephone_number": "269-365-3279",
            "fax_number": "269-781-9290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1096 34TH ST",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490109305",
            "telephone_number": "269-365-3279",
            "fax_number": "269-781-9290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWAAL",
        "first_name": "JACQUELYN",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-03",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101006233",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101006797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• County of Allegan
• David P and Mona E Ruse
• William Dewitt Davis, MD. FAAP
• Dejonge Physical Therapy, LLC
• Jennifer Ann Dentler, NP-C
• Jamie Lee Dickerson, M.A. LPC
• Timothy Dickinson, MD
• Cassie Marie Dill, M.S. OTR/L
• Terri L Doezema, LLP
• Meghan Noud Dopp, PA-C

• Speech-Language Pathologist in Allegan, MI
• Providers in Allegan, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; 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.