Innovative Speech Therapy

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

INNOVATIVE SPEECH THERAPY

Practice address

5801 Lowell St NE
26B
Albuquerque, NM 87111-5942

Phone

(505) 417-3045

Fax

(505) 294-8989

NPI assigned

Jan 13, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Stacie Gray, M.S., CCC-SLP

Title

Speech-Language Pathologist

Phone

(505) 417-3045

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1263340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263340800000",
    "number": "1275863250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 LOWELL ST NE",
            "address_2": "26B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871115942",
            "telephone_number": "505-417-3045",
            "fax_number": "505-294-8989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 LOWELL ST NE",
            "address_2": "26B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871115942",
            "telephone_number": "505-417-3045",
            "fax_number": "505-294-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE SPEECH THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-13",
        "last_updated": "2010-01-13",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "STACIE",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "505-417-3045",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.S., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90079744",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Innerwork Psychotherapy and Counseling
• Innova Vein and Vascular LLC
• Innovative Health at Home Incorporated
• Innovative Mat Solutions, LLC
• Innovative Senior Care Home Health of Albuquerque LLC
• Sean Inocencio
• Inquiring Minds Consulting, LLC
• Inside-Out Psychological Services
• Insight Counseling
• Insights Counseling, LLC

• Speech-Language Pathologist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Speech-Language Pathologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.