Individual provider Active NPI

Maribel Willson, M.S.CCC SLP,TSSLD,BE

  • Speech-Language Pathologist
  • Collingswood, NJ
National Provider Identifier
1114259850
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
41YS00849400 Issued in NJ
Practice address
1118 Park Ave
Collingswood, NJ 08108-3317
Phone
(856) 425-2238
Fax
(856) 210-7488
NPI assigned
Feb 5, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 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 PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 41YS00849400 NJ Primary

Addresses

Primary practice location

1118 Park Ave
Collingswood, NJ 08108-3317

Mailing address

1118 Park Av
Collingswood, NJ 08108
Phone (856) 425-2238

Other names 1

  • Maribel Arriaga Former name

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)
Enrolled
Credentials
Bachelor or Engineering, Master of Science

State licenses

LicenseStateTypeSpecialty
41YS00849400NJMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
South Jersey Speech Language Pathology PastSince Jun 18, 2011 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1265328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1114259850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 PARK AV",
            "city": "COLLINGSWOOD",
            "state": "NJ",
            "postal_code": "08108",
            "telephone_number": "856-425-2238",
            "fax_number": "856-210-7488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 PARK AVE",
            "city": "COLLINGSWOOD",
            "state": "NJ",
            "postal_code": "081083317",
            "telephone_number": "856-425-2238",
            "fax_number": "856-210-7488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLSON",
        "first_name": "MARIBEL",
        "name_prefix": "Mrs.",
        "credential": "M.S.CCC SLP,TSSLD,BE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00849400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIBEL",
            "last_name": "ARRIAGA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Collingswood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.