Suzan L. Larocca, MS-SLP/CCC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA12777 Issued in FL

Practice address

4310 Metro Pkwy Ste 205
Fort Myers, FL 33916-9416

Phone

(833) 362-7935

NPI assigned

Apr 28, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Suzan L McKenna Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dna Comprehensive Therapy Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Myers, FL
  • NPI 1316363757

  Speech-Language Pathologist

  Medicare reassignment NPD
• Bonita Springs Retirement Village, Inc.

  • Skilled Nursing Facility
  • Bonita Springs, FL
  • NPI 1700126802
  NPD
• Hlca, Inc.

  • Psychiatry Physician
  • West Hollywood, CA
  • NPI 1437585882
  NPD (past)

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1316112519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 METRO PKWY STE 205",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339169416",
            "telephone_number": "833-362-7935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4310 METRO PKWY STE 205",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339169416",
            "telephone_number": "833-362-7935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAROCCA",
        "first_name": "SUZAN",
        "middle_name": "L.",
        "name_prefix": "Mrs.",
        "credential": "MS-SLP/CCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-28",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA12777",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "7357",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHA CERTIFICATE OF CLINICAL COMPETENCE",
            "identifier": "12111287",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://speechlanguageliteracy.net/",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "website",
            "address_1": "15050 Elderberry Ln",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339078504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SUZAN",
            "last_name": "MCKENNA",
            "middle_name": "L",
            "credential": "MS-SLP/CCC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Larc, Inc.
• Nicholas Lariccia, M.D.
• Cathy Jean Larino, PT
• Adam Larivee
• Stephen Grant Larkin, M.D.
• Benjamin Laroche
• Cristina Maria Larrazaleta Fajardo, M.D.
• Maria Celis Larrea, RPH
• Michael Larrea, PHARMD
• Richard A Larsen, PA-C

• Speech-Language Pathologist in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.