Active NPI
Marissa Young, MA CCC-SLP
- Speech-Language Pathologist
- New Iberia, LA
National Provider Identifier
1235754102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 8010
- Practice address
- 110 E Main St
New Iberia, LA 70560-3725 - Phone
- (337) 577-4100
- NPI assigned
- Jun 16, 2020
- 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 | 8010 | LA | Primary |
Addresses
Primary practice location
110 E Main St
New Iberia, LA 70560-3725
Mailing address
3913 Highway 14
New Iberia, LA 70560-9435
Phone (337) 577-4100
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | young.marissa@gmail.com |
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8010 | LA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592265600000",
"number": "1235754102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3913 HIGHWAY 14",
"city": "NEW IBERIA",
"state": "LA",
"postal_code": "705609435",
"telephone_number": "337-577-4100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 E MAIN ST",
"city": "NEW IBERIA",
"state": "LA",
"postal_code": "705603725",
"telephone_number": "337-577-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "MARISSA",
"credential": "MA CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-16",
"last_updated": "2020-06-16",
"certification_date": "2020-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "LA",
"license": "8010",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "young.marissa@gmail.com",
"affiliation": "N",
"address_1": "110 E Main St",
"city": "New Iberia",
"state": "LA",
"country_code": "US",
"postal_code": "705603725",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in New Iberia, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.