Kelly A Coucci, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · North Dartmouth, MA
NPI 1285709717 · NPPES record last updated Apr 21, 2020
Key facts
- NPI
- 1285709717
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 4517 (MA)
- Practice address
- 299 Faunce Corner Road
2ND Floor
North Dartmouth, MA 02747 - Phone
- (508) 995-0700
- Fax
- (508) 973-1355
- NPI assigned
- Nov 21, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southcoast Physicians Group Inc
Practice addresses (Care Compare)
534 Prospect St
Fall River, MA 02720-5281
Phone (508) 973-7766
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091013000301 | MA | Practitioner - Qualified Speech Language Pathologist | 3971649559 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4517 | MA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southcoast Physicians Group, Inc. | Current |
Accepting new patients | |
| Southcoast Physicians Group, Inc. | Current | Accepting new patients | |
| Southcoast Physicians Group, Inc. | Current |
Accepting new patients | |
| Northeast ENT, Inc | Past |
Accepting new patients |
Locations
200 Mill Rd
Ste 180
Fairhaven, MA 02719
Phone (508) 973-2000
534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766
299 Faunce Corner Rd
North Dartmouth, MA 02747
Phone (508) 995-0700
299 Faunce Corner Rd
Fl 2
North Dartmouth, MA 02747
Phone (508) 973-1550
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 4517 | MA | Yes |
Addresses
Primary practice location
299 Faunce Corner Road
2ND Floor
North Dartmouth, MA 02747
Mailing address
200 Mill Rd
Suite 180
Fairhaven, MA 02719-5252
Phone (508) 973-2000
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kcoucci18679@direct.southcoast.org |
Other providers in North Dartmouth, MA
- Kathryn Frances Collins
- Breana Cordeiro
- Jaimie Cordeiro
- Michael J Corrigan
- Joshua Costa
- Carrie Cox
- Sarah Anne Crowley
- CVS Pharmacy Inc.
- D&T Behavioral Health, LLC.
- Monica S Da Silva
All providers in North Dartmouth, MA · Speech-Language Pathologist in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 21, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.