Active NPI
Jordyn Sebastian, SLP
- Speech-Language Pathologist
- Livonia, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 7101008444
- Practice address
- 11878 Hubbard St Ste 100
Livonia, MI 48150-1733 - Phone
- (734) 953-1745
- Fax
- (734) 953-1743
- NPI assigned
- Oct 10, 2019
- Sex
- Female
- Sole proprietor
- No
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 | 7101008444 | MI | Primary |
Addresses
Primary practice location
11878 Hubbard St Ste 100
Livonia, MI 48150-1733
Mailing address
4949 Coolidge Hwy
Royal Oak, MI 48073-1026
Phone (248) 655-5880
Other practice location 1
4949 Coolidge Hwy
Royal Oak, MI 48073-1026
Phone (248) 655-5880
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497760086 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
11878 Hubbard St
Livonia, MI 48150-1733
Phone (734) 953-1745
15500 19 Mile Rd
Suite 330
Clinton TWP, MI 48038-6313
Phone (586) 412-0016
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7101008444 | MI | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Recovery Project, LLC | Speech-Language Pathologist | Current | Accepting new patients |
Locations
15500 19 Mile Rd
Ste 330
Clinton Twp, MI 48038
Phone (586) 412-0016
11878 Hubbard St
Livonia, MI 48150
Phone (734) 953-1745
11878 Hubbard St
Ste 100
Livonia, MI 48150
Phone (734) 743-2909
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1570665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724284800000",
"number": "1194367292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4949 COOLIDGE HWY",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480731026",
"telephone_number": "248-655-5880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11878 HUBBARD ST STE 100",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481501733",
"telephone_number": "734-953-1745",
"fax_number": "734-953-1743"
}
],
"practiceLocations": [
{
"address_1": "4949 Coolidge Hwy",
"address_purpose": "LOCATION",
"city": "Royal Oak",
"state": "MI",
"postal_code": "480731026",
"country_code": "US",
"telephone_number": "248-655-5880",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SEBASTIAN",
"first_name": "JORDYN",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-10",
"last_updated": "2024-08-22",
"certification_date": "2024-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MI",
"license": "7101008444",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1497760086",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Livonia, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.