Sherilyn Hazen, SLP

Primary specialty

Local Education Agency (LEA)Taxonomy code 251300000X

License

SLPL0632 Issued in AZ

Practice address

4650 W Sweetwater Ave
Glendale, AZ 85304-1505

Phone

(602) 347-2600

Fax

(602) 347-2709

NPI assigned

Oct 25, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1193270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1174702245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 W KELTON LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850237930",
            "telephone_number": "602-843-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W SWEETWATER AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853041505",
            "telephone_number": "602-347-2600",
            "fax_number": "602-347-2709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZEN",
        "first_name": "SHERILYN",
        "name_prefix": "Ms.",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-25",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "AZ",
            "license": "SLPL0632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "583436",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Local Education Agency (LEA) in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Local Education Agency (LEA) in Arizona

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

Verify at the official NPI Registry.