Individual provider Active NPI

Nicole Paquin, CCC SLP

  • Speech-Language Pathologist
  • Denver, CO
National Provider Identifier
1336819978
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP.0005632 Issued in CO
Practice address
4580 Dearborn St
Denver, CO 80239-5424
Phone
(720) 424-5070
NPI assigned
Sep 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP01721 RI
Speech-Language Pathologist 235Z00000X SLP78470 MA
Speech-Language Pathologist 235Z00000X SLP.0005632 CO Primary

Addresses

Primary practice location

4580 Dearborn St
Denver, CO 80239-5424

Mailing address

13 Meadowsweet TRL
Attleboro, MA 02703-6555
Phone (150) 824-3776

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
SLP.0005632COMDSpeech-Language Pathologist
SLP78470MAMDSpeech-Language Pathologist
SP01721RIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1336819978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 MEADOWSWEET TRL",
            "city": "ATTLEBORO",
            "state": "MA",
            "postal_code": "027036555",
            "telephone_number": "150-824-3776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4580 DEARBORN ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802395424",
            "telephone_number": "720-424-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAQUIN",
        "first_name": "NICOLE",
        "credential": "CCC SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-15",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "RI",
            "license": "SP01721",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "SLP78470",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "SLP.0005632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; 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.