Individual provider Active NPI

Rebecca Mary Halley, MA, CCC-SLP

  • Speech-Language Pathologist
  • Georgetown, TX
National Provider Identifier
1366066722
Registry record updated Jun 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
107470 Issued in TX
Practice address
285 SE Inner Loop Ste 108
Georgetown, TX 78626-2139
Phone
(512) 763-1393
NPI assigned
Jun 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2020

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 107470 TX Primary

Addresses

Primary practice location

285 SE Inner Loop Ste 108
Georgetown, TX 78626-2139

Mailing address

3831 Haleys Way
Round Rock, TX 78665-1155
Phone (573) 275-7720

Other names 1

  • Rebecca Mary Klazynski Former name

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 Arts

State licenses

LicenseStateTypeSpecialty
107470TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1591056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591056000000",
    "number": "1366066722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3831 HALEYS WAY",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651155",
            "telephone_number": "573-275-7720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 SE INNER LOOP STE 108",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786262139",
            "telephone_number": "512-763-1393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLEY",
        "first_name": "REBECCA",
        "middle_name": "MARY",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-02",
        "last_updated": "2020-06-02",
        "certification_date": "2020-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "107470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "KLAZYNSKI",
            "middle_name": "MARY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Georgetown, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.