Saratoga Speech Therapy LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL00003239 Issued in WA

Legal business name

SARATOGA SPEECH THERAPY LLC

Practice address

4364 Clyde Rd
Langley, WA 98260-9540

Phone

(360) 221-7404

NPI assigned

Nov 3, 2011

Organization subpart

No

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

Authorized official

Name

Sue Keblusek, MA, CCC-SLP

Title

Owner

Phone

(360) 221-7404

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1320278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320278400000",
    "number": "1356628457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4364 CLYDE RD",
            "city": "LANGLEY",
            "state": "WA",
            "postal_code": "982609540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4364 CLYDE RD",
            "city": "LANGLEY",
            "state": "WA",
            "postal_code": "982609540",
            "telephone_number": "360-221-7404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SARATOGA SPEECH THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-03",
        "last_updated": "2011-11-03",
        "status": "A",
        "authorized_official_last_name": "KEBLUSEK",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-221-7404",
        "authorized_official_credential": "MA, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL00003239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Langley, WA
• Providers in Langley, WA by specialty
• Speech-Language Pathologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; 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.