Individual provider Active NPI

Andrea Gugliuzza, CCC-SLP

  • Speech-Language Pathologist
  • Bossier City, LA
National Provider Identifier
1154012318
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
14299960 Issued in LA
Practice address
2500 Viking Dr
Bossier City, LA 71111-2104
Phone
(318) 549-6887
NPI assigned
May 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2023

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 14299960 LA Primary

Addresses

Primary practice location

2500 Viking Dr
Bossier City, LA 71111-2104

Mailing address

4104 Ashford Cir
Benton, LA 71006-9334
Phone (318) 422-6722

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

LicenseStateTypeSpecialty
14299960LAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1684368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1154012318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4104 ASHFORD CIR",
            "city": "BENTON",
            "state": "LA",
            "postal_code": "710069334",
            "telephone_number": "318-422-6722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 VIKING DR",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112104",
            "telephone_number": "318-549-6887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUGLIUZZA",
        "first_name": "ANDREA",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-18",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "LA",
            "license": "14299960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bossier City, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; 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.