NPIMap

Organization Active NPI

Speech Therapy Associates a Speech Language Pathology Corporation

  • Speech-Language Pathologist
  • Lodi, CA
National Provider Identifier
1356493589
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP9927 Issued in CA
Legal business name
SPEECH THERAPY ASSOCIATES A SPEECH LANGUAGE PATHOLOGY CORPORATION
Practice address
1209 W Tokay St Ste 8
Lodi, CA 95240-3845
Phone
(209) 334-0830
Fax
(209) 334-0860
NPI assigned
Jan 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Colleen Adair Selling, CCC-SLPNPI 1083826036
Title
Speech Language Pathologist
Phone
(209) 334-0830

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X SP9927 CA Primary

Addresses

Primary practice location

1209 W Tokay St Ste 8
Lodi, CA 95240-3845

Mailing address

1209 W Tokay St Ste 8
Lodi, CA 95240-3845
Phone (209) 334-0830

National Provider Directory

National Provider Directory
Tax ID family
Speech Therapy Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1209 W Tokay St
Ste 8
Lodi, CA 95240
Phone (209) 334-0830

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356493589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 W TOKAY ST STE 8",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952403845",
            "telephone_number": "209-334-0830",
            "fax_number": "209-334-0860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 W TOKAY ST STE 8",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952403845",
            "telephone_number": "209-334-0830",
            "fax_number": "209-334-0860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEECH THERAPY ASSOCIATES A SPEECH LANGUAGE PATHOLOGY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SELLING",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_middle_name": "ADAIR",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "209-334-0830",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP9927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lodi, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.