Individual provider Active NPI

Denise Leverty, ST

  • Speech-Language Pathologist
  • Fairfield, CT
National Provider Identifier
1104948801
Registry record updated May 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
002633 Issued in CT
Practice address
2505 Black Rock Tpke Ste 2
Fairfield, CT 06825-2408
Phone
(203) 814-2320
NPI assigned
Apr 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2022

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 002633 CT Primary

Addresses

Primary practice location

2505 Black Rock Tpke Ste 2
Fairfield, CT 06825-2408

Mailing address

2505 Black Rock Tpke Ste 2
Fairfield, CT 06825-2408
Phone (203) 814-2320

Other practice location 1

111 New Haven Ave
Derby, CT 06418-2197
Phone (203) 735-8336

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
002633CTMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1104948801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 BLACK ROCK TPKE STE 2",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068252408",
            "telephone_number": "203-814-2320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 BLACK ROCK TPKE STE 2",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068252408",
            "telephone_number": "203-814-2320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 New Haven Ave",
            "address_purpose": "LOCATION",
            "city": "Derby",
            "state": "CT",
            "postal_code": "064182197",
            "country_code": "US",
            "telephone_number": "203-735-8336",
            "fax_number": "203-735-3704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEVERTY",
        "first_name": "DENISE",
        "credential": "ST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CT",
            "license": "002633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.