The Speech Mentor LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146013575 Issued in IL

Legal business name

THE SPEECH MENTOR LLC

Practice address

6100 S Woodlawn Ave Apt G
Chicago, IL 60637-6063

Phone

(248) 747-1132

Fax

(773) 599-9475

NPI assigned

Aug 16, 2017

Organization subpart

No

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

Authorized official

Name

Treasyri Williams, M.A.,CCC-SLP

Title

Speech Language Pathologist

Phone

(248) 747-1132

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Treasyri Williams Wood, SLPD, CCC-SLP

  • Speech-Language Pathologist
  • Chicago, IL
  • NPI 1144501172
  NPD

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

{
    "created_epoch": "1502841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502841600000",
    "number": "1124544630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 S WOODLAWN AVE APT G",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606374092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 S WOODLAWN AVE APT G",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606376063",
            "telephone_number": "248-747-1132",
            "fax_number": "773-599-9475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SPEECH MENTOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-16",
        "last_updated": "2017-08-16",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "TREASYRI",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "248-747-1132",
        "authorized_official_credential": "M.A.,CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146013575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "11444501172",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144501172",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2017; 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.