Kelly Aileen Gottschalk

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

03866 Issued in MD

Practice address

2225 Old Emmorton Rd Ste 210
Bel Air, MD 21015-6123

Phone

(410) 515-4900

Fax

(410) 515-0777

NPI assigned

Jan 21, 2019

Last updated

Jan 22, 2019By 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

Other identifiers 1

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.

• The Maryland Therapy Network, Inc

  • Speech-Language Pathologist
  • Bel Air, MD
  • NPI 1770611394
  NPD (past)

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

{
    "created_epoch": "1548028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548115200000",
    "number": "1215401542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 OLD EMMORTON RD STE 210",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210156123",
            "telephone_number": "410-515-4900",
            "fax_number": "410-515-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 OLD EMMORTON RD STE 210",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210156123",
            "telephone_number": "410-515-4900",
            "fax_number": "410-515-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTSCHALK",
        "first_name": "KELLY",
        "middle_name": "AILEEN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-21",
        "last_updated": "2019-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "03866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "419800000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony Gordon, LCPC
• Samantha Gordon, LMSW
• Reena Gorenstein, M.SC.
• Nicole Gorzovalitis, LMSW
• Sandra Goscinski, OT
• Graceful Speech-Language Therapy
• Graceway Health Care LLC
• Meghan Terese Grahe, CRNP
• Rachel Granata, PT, DPT
• Karen Grande, CCC SLP

• Speech-Language Pathologist in Bel Air, MD
• Providers in Bel Air, MD by specialty
• Speech-Language Pathologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; 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.