Individual provider Active NPI

Mia Deibert

  • Speech-Language Pathologist
  • Lititz, PA
National Provider Identifier
1265323265
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
3001 Lititz Pike
Lititz, PA 17543-9414
Phone
(717) 569-2657
NPI assigned
Jul 9, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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 Primary

Addresses

Primary practice location

3001 Lititz Pike
Lititz, PA 17543-9414

Mailing address

142 Bent Tree Dr
Lancaster, PA 17603-9436
Phone (717) 681-2520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250908004101 PA Practitioner - Qualified Speech Language Pathologist 8123520103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

142 Bent Tree Dr
Lancaster, PA 17603-9436

7125 Janes Ave
Suite 300
Woodridge, IL 60517-2347

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cortlyn Therapy, PC Speech-Language Pathologist CurrentSince Aug 4, 2025 Accepting new patients

Locations

28100 Torch Pkwy
Ste 600
Warrenville, IL 60555
Phone (630) 250-4576

7125 Janes Ave
Ste 300
Woodridge, IL 60517
Phone (630) 413-5817

502 Elizabeth Dr
Lancaster, PA 17601
Phone (223) 883-1620

1215 Hulton Rd
Oakmont, PA 15139
Phone (412) 659-2450

1361 E Boot Rd
West Chester, PA 19380
Phone (484) 653-1200

Organizations & group practices 1

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": "1752019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1265323265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 BENT TREE DR",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176039436",
            "telephone_number": "717-681-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 LITITZ PIKE",
            "city": "LITITZ",
            "state": "PA",
            "postal_code": "175439414",
            "telephone_number": "717-569-2657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEIBERT",
        "first_name": "MIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-09",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lititz, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.