Michelle Dahlberg, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP-1147 Issued in ID

Practice address

1460 Elk Creek Dr
Idaho Falls, ID 83404-8237

Phone

(208) 535-1286

Fax

(208) 535-1291

NPI assigned

Jul 24, 2006

Last updated

Mar 9, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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)

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 and Language Clinic, Inc

  • Speech-Language Pathologist
  • Ammon, ID
  • NPI 1891953519
  Authorized official Same address or phone
• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  NPD (past)

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1255353488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 S HIGHLINE DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834015909",
            "telephone_number": "208-604-1286",
            "fax_number": "208-535-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 ELK CREEK DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048237",
            "telephone_number": "208-535-1286",
            "fax_number": "208-535-1291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHLBERG",
        "first_name": "MICHELLE",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "SLP-1147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stewart Ryan Curtis, DO, MPH
• Gwen Marie Cutler, LMSW
• Logan Daniel Cutts, FNP-C
• D7 Treatment (Madison County)
• Sheila Marie Dabell, LCSW
• Chad Steven Dahle, RCS
• Clark R Daines, MD
• Dallco Orthopaedics and Sports Medicine
• Audrey Dalley, LPN
• Jason Dallimore, LPC

• Speech-Language Pathologist in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Speech-Language Pathologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.