NPIMap

Organization Active NPI

Edmond Speech Therapy LLC

  • Speech-Language Pathologist
  • Edmond, OK
National Provider Identifier
1245995059
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
EDMOND SPEECH THERAPY LLC
Practice address
209 Lilac Dr Ste 130
Edmond, OK 73034-7208
Phone
(405) 295-5753
Fax
(405) 562-7034
NPI assigned
Nov 5, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Carlee Harris, M.A. CCC-SLPNPI 1053886200
Title
Member, Speech-Language Pathologist
Phone
(405) 295-5753

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

209 Lilac Dr Ste 130
Edmond, OK 73034-7208

Mailing address

209 Lilac Dr Ste 130
Edmond, OK 73034-7208
Phone (405) 295-5753

National Provider Directory

National Provider Directory

Locations

209 Lilac Dr
Ste 130
Edmond, OK 73034
Phone (405) 295-5753

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1636070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641340800000",
    "number": "1245995059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 LILAC DR STE 130",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730347208",
            "telephone_number": "405-295-5753",
            "fax_number": "405-562-7034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 LILAC DR STE 130",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730347208",
            "telephone_number": "405-295-5753",
            "fax_number": "405-562-7034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDMOND SPEECH THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-05",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "CARLEE",
        "authorized_official_title_or_position": "MEMBER, SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "405-295-5753",
        "authorized_official_credential": "M.A. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; 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.