Marissa J Chiang, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2859-154 Issued in WI

Practice address

2927 S Fish Hatchery Rd
Fitchburg, WI 53711-6498

Phone

(608) 819-6394

NPI assigned

Oct 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 2

Addresses

Other identifiers 1

Other names 1

• Marissa J Douglas Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Communication Innovations, LLC

  • Clinic/Center
  • Fitchburg, WI
  • NPI 1508033564
  NPD (past)

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1154404374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2927 S FISH HATCHERY RD",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537116498",
            "telephone_number": "608-819-6394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2927 S FISH HATCHERY RD",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537116498",
            "telephone_number": "608-819-6394"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9220 Bass Lake Road",
            "address_2": "Suite 260",
            "address_purpose": "LOCATION",
            "city": "New Hope",
            "state": "MN",
            "postal_code": "554283000",
            "country_code": "US",
            "telephone_number": "763-533-0363",
            "fax_number": "763-533-0842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHIANG",
        "first_name": "MARISSA",
        "middle_name": "J",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "2859-154",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "8287",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42580000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "DOUGLAS",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rachel Carmen
• Joseph L Cermak, MS, BCBA
• Tobin Joseph Chambers, PHARMD
• Micah R Chan, MD
• Sara Ann Chellevold, PHARMD
• Nathaniel Ark Chin, M.D.
• Eunju Cho, NP
• Catherine Ruth Christopherson, PHARMD
• Mikayla Chryst
• Hayley Clark, LMFT

• Speech-Language Pathologist in Fitchburg, WI
• Providers in Fitchburg, WI by specialty
• Speech-Language Pathologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2020; 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.