Sadie Johanna Fullam, EDD

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

77277 Issued in MA

Practice address

454 Main St
Sturbridge, MA 01518-1216

Phone

(508) 301-2933

NPI assigned

Jun 19, 2015

Last updated

Jun 3, 2025By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Speech Language Nook Therapy Center

  • Hearing and Speech Clinic/Center
  • Sturbridge, MA
  • NPI 1497648877
  NPD Authorized official

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1215319843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 HAWTHORNE RD",
            "city": "STURBRIDGE",
            "state": "MA",
            "postal_code": "015661219",
            "telephone_number": "508-344-4843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 MAIN ST",
            "city": "STURBRIDGE",
            "state": "MA",
            "postal_code": "015181216",
            "telephone_number": "508-301-2933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLAM",
        "first_name": "SADIE",
        "middle_name": "JOHANNA",
        "name_prefix": "Dr.",
        "credential": "EDD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-19",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "77277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Casey Fairbrother, PHARMD
• Junjie Fang, M.D.
• Ashraf Farid, MD
• Form First Physical Therapy LLC
• Cynthia E Fugere, LMFT, LMHC, M.ED
• Amy J Gaudette, LIC. AC.
• Daniel Gaunya, DC
• Steven J Gaunya, D.C.
• Gennady Gelman, M.D.
• Richard Allen Gendreau, LMHC,LADC,CEAP,CADAC

• Speech-Language Pathologist in Sturbridge, MA
• Providers in Sturbridge, MA by specialty
• Speech-Language Pathologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2025; 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.