Stacey Delforge

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

1708154 Issued in WI

Practice address

337 Main St
Birnamwood, WI 54414-9259

Phone

(715) 449-2576

NPI assigned

Mar 12, 2012

Last updated

Mar 12, 2012By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1331510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331510400000",
    "number": "1366717233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P1561 OLD LAKE RD",
            "city": "BIRNAMWOOD",
            "state": "WI",
            "postal_code": "544149418",
            "telephone_number": "715-449-3362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "337 MAIN ST",
            "city": "BIRNAMWOOD",
            "state": "WI",
            "postal_code": "544149259",
            "telephone_number": "715-449-2576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELFORGE",
        "first_name": "STACEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-12",
        "last_updated": "2012-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "1708154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cori Ann Bauch, RN
• Birnamwood Area Ambulance
• Blade Richard Cameron
• Langlade Hospital - Hotel Dieu of St Joseph of Antigo Wisconsin (Aspirus Birnamwood Clinic)
• Sheryl Lynn Melotik
• Melody Ann Michalski, RN
• Larry Lee Nillissen, DDS
• Amanda Onesti

• Speech-Language Pathologist in Birnamwood, WI
• Providers in Birnamwood, WI by specialty
• Speech-Language Pathologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2012; 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.