Maria Fenicle, MA CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

2922 Fuller Ave NE Ste 107
Grand Rapids, MI 49505-3459

Phone

(616) 570-0925

NPI assigned

Dec 22, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Maria Flory Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Building Blocks Foundation, Inc

  • Speech-Language Pathologist
  • Grand Rapids, MI
  • NPI 1609589589
  NPD

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

{
    "created_epoch": "1671667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1336851211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2922 FULLER AVE NE STE 107",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495053459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2922 FULLER AVE NE STE 107",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495053459",
            "telephone_number": "616-570-0925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENICLE",
        "first_name": "MARIA",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-22",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "FLORY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jon Robert Felt, M.D.
• Lauren Felten
• Savannah Joy Felten I
• David Robert Felton, DC
• Isabella Felzer-Kim
• Amanda Kimberly Fenn
• Katie Fennell, LMSW
• Grace Elizabeth Fennema
• Jason Fennema, CRNA
• Meredith Fennema

• Speech-Language Pathologist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2022; 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.