Individual provider Active NPI

Melissa Hundley Wolak, MS, CCC-SLP

  • Speech-Language Pathologist
  • Boulder, CO
National Provider Identifier
1124248893
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP004255 Issued in GA
Practice address
311 Mapleton Ave
Boulder, CO 80304-3979
Phone
(303) 441-0437
NPI assigned
Apr 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 SLP004255 GA Primary

Addresses

Primary practice location

311 Mapleton Ave
Boulder, CO 80304-3979

Mailing address

4674 White Rock Cir Apt 9
Boulder, CO 80301-6704
Phone (720) 341-5564

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240909004442 CO Practitioner - Qualified Speech Language Pathologist 6800336520 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boulder Cognitive and Linguistic Center IncGroup PAC ID 5092027409, 21 clinicians

Practice addresses (Care Compare)

4251 Kipling St
Unit 405
Wheat Ridge, CO 80033-6833
Phone (303) 932-2030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SLP004255GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Cognitive and Linguistic Center Inc CurrentSince Jul 1, 2025 Accepting new patients
Legacy Healthcare Services Inc. Speech-Language Pathologist CurrentSince Aug 19, 2024 Accepting new patients
Legacy Healthcare Services Inc Speech-Language Pathologist CurrentSince Aug 19, 2024 Accepting new patients
Boulder Cognitive and Linguistic Center Inc Speech-Language Pathologist CurrentSince Jul 1, 2025 Accepting new patients

Locations

4251 Kipling St
Unit 405
Wheat Ridge, CO 80033
Phone (303) 932-2030

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

Organizations & group practices 4

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": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124248893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4674 WHITE ROCK CIR APT 9",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803016704",
            "telephone_number": "720-341-5564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 MAPLETON AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043979",
            "telephone_number": "303-441-0437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLAK",
        "first_name": "MELISSA",
        "middle_name": "HUNDLEY",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP004255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.