Stacy Marie Mate

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP.13113 Issued in OH

Practice address

111 W Grand Valley Ave
Orwell, OH 44076-9437

Phone

(440) 805-4545

NPI assigned

Aug 25, 2017

Last updated

Jan 5, 2021By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1503619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1154848661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1689 CHAPEL RD",
            "city": "JEFFERSON",
            "state": "OH",
            "postal_code": "440478716",
            "telephone_number": "440-994-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W GRAND VALLEY AVE",
            "city": "ORWELL",
            "state": "OH",
            "postal_code": "440769437",
            "telephone_number": "440-805-4545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 Wade Ave",
            "address_purpose": "LOCATION",
            "city": "Ashtabula",
            "state": "OH",
            "postal_code": "440049435",
            "country_code": "US",
            "telephone_number": "440-992-1270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATE",
        "first_name": "STACY",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-25",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "COND.2017342-SP",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.13113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Jacques
• Keystone Rehabilitation Systems Inc (NovaCare Rehabilitation)
• Kenneth L Lawrence, DDS
• Joan D Limpert, STNA
• Brenda Loomis
• Neil Raymond Meloro, ED. S.
• Mogans Drugs Store Incorporated (Grand Valley Drug)
• Sandra Nims, LPN
• Heather M Olah, LPN
• Paul Ware (Tap)

• Speech-Language Pathologist in Orwell, OH
• Providers in Orwell, OH by specialty
• Speech-Language Pathologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.