Active NPI
Courtney Souza, CCC-SLP
- Speech-Language Pathologist
- Quincy, MA
National Provider Identifier
1114540481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 77528-SP-SL
- Practice address
- 1266 Furnace Brook Pkwy Ste 100B
Quincy, MA 02169-4789 - Phone
- (617) 433-7699
- NPI assigned
- May 21, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 77528-SP-SL | MA | Primary |
Addresses
Primary practice location
1266 Furnace Brook Pkwy Ste 100B
Quincy, MA 02169-4789
Mailing address
941 Furnace Brook Pkwy Apt 4
Quincy, MA 02169-1654
Phone (617) 429-5453
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
| License | State | Type | Specialty |
|---|---|---|---|
| 77528-SP-SL | MA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Puzzle Pieces, LLC | Speech-Language Pathologist | Past | 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": "1590019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590019200000",
"number": "1114540481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "941 FURNACE BROOK PKWY APT 4",
"city": "QUINCY",
"state": "MA",
"postal_code": "021691654",
"telephone_number": "617-429-5453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1266 FURNACE BROOK PKWY STE 100B",
"city": "QUINCY",
"state": "MA",
"postal_code": "021694789",
"telephone_number": "617-433-7699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUZA",
"first_name": "COURTNEY",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-21",
"last_updated": "2020-05-21",
"certification_date": "2020-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MA",
"license": "77528-SP-SL",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Quincy, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.