Cassidy Phoenix

Primary specialty

Speech-Language AssistantTaxonomy code 2355S0801X

License

SLPA10517 Issued in AZ

Practice address

37 Oceanic LN
Lake Havasu City, AZ 86403-5434

Phone

(702) 501-1143

NPI assigned

Apr 12, 2017

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)

Not 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 and National Provider Directory roles.

• Brighter Beginnings Therapy

  • Hearing and Speech Clinic/Center
  • Lake Havasu City, AZ
  • NPI 1689562514
  NPD Authorized official

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1255865648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3887 BLUEGRASS DR",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864064362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 OCEANIC LN",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035434",
            "telephone_number": "702-501-1143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHOENIX",
        "first_name": "CASSIDY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-12",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "AZ",
            "license": "SLPA10517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert D Peterson, MD
• Petersons Home Care Inc
• PHC-Lake Havasu Inc
• Douglas George Pheling, MA
• Philip a St Raymond MD PLLC
• Physicians Integrated Health Group LLC
• Carol Pichardo
• Pinnacle Healthcare LLC
• Pinnacle Radiology Services
• Janet Sue Pippin, P.T.

• Speech-Language Assistant in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Speech-Language Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.