Individual provider Active NPI

Brooke Lauren Fletcher

  • Speech-Language Pathologist
  • Mount Laurel, NJ
National Provider Identifier
1366103335
Registry record updated Jan 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
3 Lavender LN
Mount Laurel, NJ 08054-5721
Phone
(856) 905-0789
NPI assigned
Jan 3, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 41YS00883200 NJ
Speech-Language Pathologist 235Z00000X NJ Primary

Addresses

Primary practice location

3 Lavender LN
Mount Laurel, NJ 08054-5721

Mailing address

3 Lavender LN
Mount Laurel, NJ 08054-5721
Phone (856) 905-0789

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

State licenses

LicenseStateTypeSpecialty
41YS00883200NJMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1641168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1366103335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 LAVENDER LN",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080545721",
            "telephone_number": "856-905-0789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 LAVENDER LN",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080545721",
            "telephone_number": "856-905-0789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "BROOKE",
        "middle_name": "LAUREN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-03",
        "last_updated": "2022-01-03",
        "certification_date": "2021-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00883200",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; 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.