Judy Lynn Pollard-Licklider, M.A.CC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

998 Issued in KS

Practice address

4921 E 21St St N
Wichita, KS 67208-1602

Phone

(316) 681-3204

Fax

(316) 681-0541

NPI assigned

Apr 17, 2007

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 identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Erin Is Hope Foundation Inc

  • Speech-Language Pathologist
  • Wichita, KS
  • NPI 1780638999
  NPD (past) Authorized official

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356567754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4921 E 21ST ST N",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672081602",
            "telephone_number": "316-681-3204",
            "fax_number": "316-681-0541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 E 21ST ST N",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672081602",
            "telephone_number": "316-681-3204",
            "fax_number": "316-681-0541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLARD-LICKLIDER",
        "first_name": "JUDY",
        "middle_name": "LYNN",
        "credential": "M.A.CC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KS",
            "license": "998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20031630B",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSKS",
            "identifier": "115161",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Poggi Plastic Surgery, PA
• Joseph T Poggi, MD
• Mackenzie M Poirier, SLP
• Caidence Dawn Lynn Polasky
• Christopher W Polk, DDS
• Brianna Pollard, PHARMD
• Jessica Renee Pollet, DNP, APRN
• Anthony G Pollock, M.D.
• Lara Pollock, MSOM, DIPL.OM, DOM
• Dione Bleu Pompa, LCPC

• Speech-Language Pathologist in Wichita, KS
• Providers in Wichita, KS by specialty
• Speech-Language Pathologist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.