Active NPI
Laura Anne Folsom, CCC-SLP
- Speech-Language Pathologist
- Phoenix, AZ
National Provider Identifier
1154524957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP0461
- Practice address
- 4545 E Shea Blvd Ste 169
Phoenix, AZ 85028-3061 - Phone
- (602) 765-6929
- Fax
- (602) 494-2930
- NPI assigned
- Jun 8, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP0461 | AZ | Primary |
Addresses
Primary practice location
4545 E Shea Blvd Ste 169
Phoenix, AZ 85028-3061
Mailing address
15436 N.1St PL.
Phoenix, AZ 85022-3002
Phone (602) 978-0529
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SLP0461 | Other | AZ | SPEECH LANGUAGE PATHOLOGI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| SLP0461 | AZ | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154524957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15436 N.1ST PL.",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850223002",
"telephone_number": "602-978-0529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4545 E SHEA BLVD STE 169",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850283061",
"telephone_number": "602-765-6929",
"fax_number": "602-494-2930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOLSOM",
"first_name": "LAURA",
"middle_name": "ANNE",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AZ",
"license": "SLP0461",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPEECH LANGUAGE PATHOLOGI",
"identifier": "SLP0461",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.