Active NPI
Corrie Castelluccio, B.A.
- Speech-Language Assistant
- Waddell, AZ
National Provider Identifier
1235307455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- 3984527
- Practice address
- 17958 W Brown St
Waddell, AZ 85355-4151 - Phone
- (623) 466-0760
- NPI assigned
- Feb 11, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 Assistant | 2355S0801X | 3984527 | AZ | Primary |
Addresses
Primary practice location
17958 W Brown St
Waddell, AZ 85355-4151
Mailing address
6610 N 93Rd Ave Apt 3113
Glendale, AZ 85305-3203
Phone (480) 235-1836
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3984527 | AZ | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309392000000",
"number": "1235307455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6610 N 93RD AVE APT 3113",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853053203",
"telephone_number": "480-235-1836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17958 W BROWN ST",
"city": "WADDELL",
"state": "AZ",
"postal_code": "853554151",
"telephone_number": "623-466-0760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASTELLUCCIO",
"first_name": "CORRIE",
"name_prefix": "Ms.",
"credential": "B.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-11",
"last_updated": "2011-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "AZ",
"license": "3984527",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waddell, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.