Linda Cullivan, SLP

Individual provider Active NPI Speech-Language Pathologist · Belen, NM

NPI 1104902261 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1104902261
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
K0505 (NM)
Practice address
520 N Main St
Belen, NM 87002-3720
Phone
(505) 966-1506
NPI assigned
Oct 31, 2006
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
K0505NMMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Belen Consolidated Schools Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X K0505 NM Yes

Addresses

Primary practice location

520 N Main St
Belen, NM 87002-3720

Mailing address

520 N Main St
Belen, NM 87002-3720

Other identifiers

IdentifierTypeStateIssuer
K0505OtherNMREGULATION & LICENSING

Other providers in Belen, NM

All providers in Belen, NM · Speech-Language Pathologist in New Mexico

Sources for this page

Verify at the official NPI Registry.