Sherry L Street-Tobin, MA CCC SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2541 Issued in NC

Practice address

1620 Stoney Brook LN
Boone, NC 28607-9385

Phone

(828) 773-6133

NPI assigned

Jul 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1114949070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 STONEY BROOK LN",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286079385",
            "telephone_number": "828-773-6133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 STONEY BROOK LN",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286079385",
            "telephone_number": "828-773-6133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREET-TOBIN",
        "first_name": "SHERRY",
        "middle_name": "L",
        "credential": "MA CCC SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-23",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "2541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7411024",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BS OF NC",
            "identifier": "13478",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cassandra Lynn Stull, MPAS, PA-C

• Speech-Language Pathologist in Boone, NC
• Providers in Boone, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.