NPIMap

Organization Active NPI

Mindful Speech Therapy Specialists PLLC

  • Speech-Language Pathologist
  • Cary, NC
National Provider Identifier
1255811386
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
11745 Issued in NC
Legal business name
MINDFUL SPEECH THERAPY SPECIALISTS PLLC
Practice address
714 Suffield Way
Cary, NC 27519-6996
Phone
(919) 625-6689
NPI assigned
Aug 17, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

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

Authorized official

Name
Tara Blizzard, MA CCC-SLPNPI 1841523271
Title
Speech Language Pathologists
Phone
(919) 625-6689

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 11745 NC Primary

Addresses

Primary practice location

714 Suffield Way
Cary, NC 27519-6996

Mailing address

714 Suffield Way
Cary, NC 27519-6996
Phone (919) 625-6689

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1534464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1255811386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 SUFFIELD WAY",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275196996",
            "telephone_number": "919-625-6689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 SUFFIELD WAY",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275196996",
            "telephone_number": "919-625-6689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL SPEECH THERAPY SPECIALISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-17",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "BLIZZARD",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGISTS",
        "authorized_official_telephone_number": "919-625-6689",
        "authorized_official_credential": "MA CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "11745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; 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.