Ciara Johnson, CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Nokomis, FL

NPI 1194270793 · NPPES record last updated Mar 21, 2025

Key facts

NPI
1194270793
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
15580 (FL)
Practice address
1308 Vermeer Dr
Nokomis, FL 34275-4464
Phone
(941) 993-2067
NPI assigned
Aug 24, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
15580FLMDSpeech-Language Pathologist
SZ7753FLMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist
Group: 193400000X SINGLE SPECIALTY GROUP
235Z00000X 15580 FL Yes
Speech-Language Pathologist 235Z00000X SZ7753 FL

Addresses

Primary practice location

1308 Vermeer Dr
Nokomis, FL 34275-4464

Mailing address

1308 Vermeer Dr
Nokomis, FL 34275-4464
Phone (941) 993-2067

Other identifiers

IdentifierTypeStateIssuer
018605300MedicaidFL
SZ7753OtherFLFLORIDA DEPARTMENT OF HEALTH
15580OtherFLFLORIDA DEPARTMENT OF HEALTH

Other providers in Nokomis, FL

All providers in Nokomis, FL · Speech-Language Pathologist in Florida

Sources for this page

Verify at the official NPI Registry.