NK Speech Therapy and Behavior Support PLLC

Primary specialty

Hearing and Speech Clinic/CenterTaxonomy code 261QH0700X

Legal business name

NK SPEECH THERAPY AND BEHAVIOR SUPPORT PLLC

Practice address

7776 S Pointe Pkwy W Ste 250
Phoenix, AZ 85044-5428

Phone

(480) 518-7073

NPI assigned

May 2, 2022

Organization subpart

No

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

Authorized official

Name

Nicole Kavanagh, CCC-SLPNPI 1922328780

Title

Owner

Phone

(480) 518-7073

Specialties & licenses 9

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicole Lynn Kavanagh, CCC-SLP

  • Speech-Language Pathologist
  • Gilbert, AZ
  • NPI 1922328780

  Single Specialty

  Medicare reassignment NPD Authorized official
• Mikeeta Beebe, MS, CCC-SLP

  • Speech-Language Pathologist
  • San Tan Valley, AZ
  • NPI 1336693688

  Speech-Language Assistant

  NPD
• Jeanette Bustamante

  • Occupational Therapist
  • Mesa, AZ
  • NPI 1134883259
  NPD (past)
• Laura Faith Fischer, SPT

  • Speech-Language Pathologist
  • Phoenix, AZ
  • NPI 1821179128
  NPD (past)
• Machelle Gliori

  • Contractor
  • Surprise, AZ
  • NPI 1477696045
  NPD (past)

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

{
    "created_epoch": "1651449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665532800000",
    "number": "1104561471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5783 S FAWN AVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852980848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7776 S POINTE PKWY W STE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850445428",
            "telephone_number": "480-518-7073"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5783 S Fawn Ave",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852980848",
            "country_code": "US",
            "telephone_number": "480-518-7073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NK SPEECH THERAPY AND BEHAVIOR SUPPORT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-02",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A",
        "authorized_official_last_name": "KAVANAGH",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-518-7073",
        "authorized_official_credential": "CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "kavanaghnicole@rocketmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5783 S Fawn Ave",
            "city": "Gilbert",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852980848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eric Njiforfut, M.D.
• Aline Amisi Njiraini, FNP
• Maureen Njoroge
• Destiny Njos, RDN
• Titus Waititu Njuguna, CERTIFIED CAREGIVER,
• Nkare Services PC
• Victor Nkem
• Bariduanen Bright Nkol, FNP
• Desire Ntajonjora Nkomezi
• Bertie Faye Nkosi

• Hearing and Speech Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Hearing and Speech Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.