Olivia J Avila, CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Meredith, NH

NPI 1275201352 · NPPES record last updated Jun 25, 2026

Key facts

NPI
1275201352
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
2203001042 (VA)
Practice address
1 Laker LN
Meredith, NH 03253-6321
Phone
(603) 279-6162
NPI assigned
Sep 2, 2021
Sex
Female
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Qualified Speech Language Pathologist
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7600 Chevy Chase Dr
Suite 300
Austin, TX 78752-1503

Medicare participation

Medicare fee-for-service enrollment
Enrolled in ME

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20260626000166 ME Practitioner - Qualified Speech Language Pathologist 0143793588

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
EL31571NHMDSpeech-Language Pathologist
118983TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
CKC Holdings LLC Past
since Mar 24, 2024
Accepting new patients
CKC Holdings LLC Past
since Feb 27, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2203001042 VA Yes
Speech-Language Pathologist 235Z00000X SP4504 ME
Speech-Language Pathologist 235Z00000X 118983 TX
Speech-Language Pathologist 235Z00000X 3294 NH

Addresses

Primary practice location

1 Laker LN
Meredith, NH 03253-6321

Mailing address

6473 Blue TRL
Arlington, TX 76001-7705
Phone (407) 408-5826

Other names

  • Olivia Mack Former name

Other providers in Meredith, NH

All providers in Meredith, NH · Speech-Language Pathologist in New Hampshire

Sources for this page

Verify at the official NPI Registry.