Active NPI
Elizabeth Clancy, CCC-SLP
- Speech-Language Pathologist
- Colorado Springs, CO
National Provider Identifier
1265815468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP.0001816
- Practice address
- 2790 N Academy Blvd
Suite 227
Colorado Springs, CO 80917-5337 - Phone
- (719) 425-7771
- Fax
- (719) 208-7730
- NPI assigned
- Jul 7, 2015
- 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 | SLP.0001816 | CO | Primary |
Addresses
Primary practice location
2790 N Academy Blvd
Suite 227
Colorado Springs, CO 80917-5337
Mailing address
15110 Copperfield Dr
Colorado Springs, CO 80921-3522
Phone (917) 817-3496
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SLP.0001816 | Other | CO | LICENSE NUMBER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| SLP.0001816 | CO | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524787200000",
"number": "1265815468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15110 COPPERFIELD DR",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809213522",
"telephone_number": "917-817-3496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2790 N ACADEMY BLVD",
"address_2": "SUITE 227",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809175337",
"telephone_number": "719-425-7771",
"fax_number": "719-208-7730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLANCY",
"first_name": "ELIZABETH",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-07-07",
"last_updated": "2018-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CO",
"license": "SLP.0001816",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "SLP.0001816",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.