Individual provider Active NPI

Madeline Ince, MS CCC-SLP

  • Speech-Language Pathologist
  • Saint Louis, MO
National Provider Identifier
1154089985
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2019018004 Issued in MO
Practice address
3800 Park Ave FL 2
Saint Louis, MO 63110-2514
Phone
(314) 678-6648
Fax
(314) 268-4028
NPI assigned
Nov 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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 2019018004 MO Primary

Addresses

Primary practice location

3800 Park Ave FL 2
Saint Louis, MO 63110-2514

Mailing address

3800 Park Ave FL 2
Saint Louis, MO 63110-2514
Phone (314) 678-6648

Other practice location 1

232 S Woods Mill Rd
Chesterfield, MO 63017-3485
Phone (314) 799-4623

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)
Enrolled
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1638144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1154089985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 PARK AVE FL 2",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102514",
            "telephone_number": "314-678-6648",
            "fax_number": "314-268-4028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 PARK AVE FL 2",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102514",
            "telephone_number": "314-678-6648",
            "fax_number": "314-268-4028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "232 S Woods Mill Rd",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "MO",
            "postal_code": "630173485",
            "country_code": "US",
            "telephone_number": "314-799-4623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "INCE",
        "first_name": "MADELINE",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-29",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2019018004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; 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.