Olivia J Avila, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2203001042 Issued in VA

Practice address

1 Laker LN
Meredith, NH 03253-6321

Phone

(603) 279-6162

NPI assigned

Sep 2, 2021

Last updated

Jun 25, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other names 1

• Olivia Mack Former name

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• CKC Holdings LLC

  dba Cornerstone Pediatric Therapy

  • Home Health Agency
  • Arlington, TX
  • NPI 1023310901

  Speech-Language Pathologist

  NPD (past)
• CKC Holdings LLC

  dba Cornerstone Pediatric Therapy

  • Behavior Analyst
  • Carrollton, TX
  • NPI 1538815055
  NPD (past)

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

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1275201352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6473 BLUE TRL",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760017705",
            "telephone_number": "407-408-5826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LAKER LN",
            "city": "MEREDITH",
            "state": "NH",
            "postal_code": "032536321",
            "telephone_number": "603-279-6162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILA",
        "first_name": "OLIVIA",
        "middle_name": "J",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-02",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2203001042",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ME",
            "license": "SP4504",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "118983",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NH",
            "license": "3294",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLIVIA",
            "last_name": "MACK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Affiliates in Podiatry PC
• Keith Evan Allen
• David H Almstrom, BS, DVM
• Aq FVM NH LLC
• Ashland School District
• Tracy Elizabeth Bourbeau
• Linda M. Brewer, LICSW, MLADC
• Julie Brooks, PTA
• Theodore H Capron, MD
• Benjamin Thomas Carbone, PHARMD

• Speech-Language Pathologist in Meredith, NH
• Providers in Meredith, NH by specialty
• Speech-Language Pathologist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2026; 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.