Individual provider Active NPI

Haley Conrad

  • Speech-Language Pathologist
  • Avon, CT
National Provider Identifier
1265122519
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
14441629 Issued in CT
Practice address
136 Simsbury Rd BLDG 16
Avon, CT 06001-3760
Phone
(860) 608-7366
NPI assigned
May 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 14441629 CT Primary

Addresses

Primary practice location

136 Simsbury Rd BLDG 16
Avon, CT 06001-3760

Mailing address

45 Westwood Dr
Simsbury, CT 06070-1719
Phone (860) 608-7366

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

State licenses

LicenseStateTypeSpecialty
14441629CTMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Speakology LLC Speech-Language Pathologist PastSince May 14, 2023 Accepting new patients
Wait Your Turn LLC Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1683676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1265122519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 WESTWOOD DR",
            "city": "SIMSBURY",
            "state": "CT",
            "postal_code": "060701719",
            "telephone_number": "860-608-7366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 SIMSBURY RD BLDG 16",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013760",
            "telephone_number": "860-608-7366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "HALEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-10",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CT",
            "license": "14441629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; 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.