Individual provider Active NPI

Delaney Lynn Johnson, MS CCC-SLP

  • Speech-Language Pathologist
  • Johnston City, IL
National Provider Identifier
1346828423
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.015727 Issued in IL
Practice address
1108 Grand Ave
Johnston City, IL 62951-1229
Phone
(618) 983-7561
NPI assigned
Mar 31, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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 146.015727 IL Primary

Addresses

Primary practice location

1108 Grand Ave
Johnston City, IL 62951-1229

Mailing address

12084 Harmony Church Rd
West Frankfort, IL 62896-7008
Phone (618) 579-6571

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
146.015727ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Small Talk Speech and Language Center Speech-Language Pathologist CurrentSince Jun 30, 2024 Accepting new patients

Locations

1120 S Park Ave
Ste 2
Herrin, IL 62948
Phone (618) 515-5738

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1346828423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12084 HARMONY CHURCH RD",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628967008",
            "telephone_number": "618-579-6571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 GRAND AVE",
            "city": "JOHNSTON CITY",
            "state": "IL",
            "postal_code": "629511229",
            "telephone_number": "618-983-7561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DELANEY",
        "middle_name": "LYNN",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-31",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.015727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnston City, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; 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.