Nicole Marie Fakoory, MA CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

118600 Issued in TX

Practice address

350 Keller Pkwy
Keller, TX 76248-2249

Phone

(817) 744-1000

NPI assigned

Jul 26, 2022

Last updated

Jul 26, 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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.

• Keller Isd

  • Local Education Agency (LEA)
  • Keller, TX
  • NPI 1679869721
  NPD (past)

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

{
    "created_epoch": "1658793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1265168884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 QUORUM DR APT 303",
            "city": "TROPHY CLUB",
            "state": "TX",
            "postal_code": "762625406",
            "telephone_number": "626-422-3840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 KELLER PKWY",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762482249",
            "telephone_number": "817-744-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKOORY",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-26",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "118600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Nicole.fakoory@kellerisd.net",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "350 Keller Pkwy",
            "city": "Keller",
            "state": "TX",
            "country_code": "US",
            "postal_code": "762482249",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Leslie Marie Faris, PH.D.
• Mary Sue Farrier, OTR
• Sabrina Farthing

• Speech-Language Pathologist in Keller, TX
• Providers in Keller, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.