Active NPI
Kelli Donovan, M.A, CCC-SLP
- Speech-Language Pathologist
- Allston, MA
National Provider Identifier
1265639447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 6105
- Practice address
- 18 Saint Lukes Rd
Apt. 2
Allston, MA 02134-3101 - Phone
- (508) 847-0396
- NPI assigned
- Jun 29, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 6105 | MA | Primary |
Addresses
Primary practice location
18 Saint Lukes Rd
Apt. 2
Allston, MA 02134-3101
Mailing address
6 Remick Ter
Newton, MA 02458-1718
Phone (508) 847-0396
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6105 | MA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185840000000",
"number": "1265639447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 REMICK TER",
"city": "NEWTON",
"state": "MA",
"postal_code": "024581718",
"telephone_number": "508-847-0396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18 SAINT LUKES RD",
"address_2": "APT. 2",
"city": "ALLSTON",
"state": "MA",
"postal_code": "021343101",
"telephone_number": "508-847-0396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONOVAN",
"first_name": "KELLI",
"credential": "M.A, CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-29",
"last_updated": "2007-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MA",
"license": "6105",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Allston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.