Individual provider Active NPI

Brenda Soverinsky

  • Speech-Language Pathologist
  • Plymouth, MI
National Provider Identifier
1316308208
Registry record updated Mar 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101001904 Issued in MI
Practice address
9357 General Dr
Plymouth, MI 48170-4662
Phone
(734) 454-0866
NPI assigned
Mar 18, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 7101001904 MI Primary

Addresses

Primary practice location

9357 General Dr
Plymouth, MI 48170-4662

Mailing address

29700 High Valley Rd
Farmington Hills, MI 48331-2164
Phone (248) 217-8311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7101001904MIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1458259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458259200000",
    "number": "1316308208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29700 HIGH VALLEY RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483312164",
            "telephone_number": "248-217-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9357 GENERAL DR",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704662",
            "telephone_number": "734-454-0866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOVERINSKY",
        "first_name": "BRENDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-18",
        "last_updated": "2016-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101001904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; 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.