Michelle Renee Hargrave, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

4367 Issued in NM

Practice address

4505 Bali CT NE
Albuquerque, NM 87111-2801

Phone

(505) 292-7104

Fax

(505) 296-2183

NPI assigned

Sep 26, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281916800000",
    "number": "1366639015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 BALI CT NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112801",
            "telephone_number": "505-292-7104",
            "fax_number": "505-296-2183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 BALI CT NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112801",
            "telephone_number": "505-292-7104",
            "fax_number": "505-296-2183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARGRAVE",
        "first_name": "MICHELLE",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-26",
        "last_updated": "2010-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "4367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04481054",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tylina Hardy, NM LMT #5901
• David Austyne Hare
• Kristen Hare, OTR/L
• Antonia Harford, MD
• Emily Harger
• John Hargraves
• Farzana M. Harji, MD
• Michelle Harkins, MD
• Joyce M Harkwell, LPCC
• Elizabeth Harley, LMHC

• Speech-Language Pathologist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Speech-Language Pathologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2010; 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.