Mary Crocker, CCC/SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

108844 Issued in TX

Practice address

817 N Mound St
Nacogdoches, TX 75961-4427

Phone

(936) 564-6907

Fax

(936) 564-0509

NPI assigned

May 21, 2014

Last updated

Oct 22, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hettie Legg & Associates

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Nacogdoches, TX
  • NPI 1396908232

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1400630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1366854606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 N MOUND ST",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614427",
            "telephone_number": "936-564-6907",
            "fax_number": "936-564-0509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 N MOUND ST",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614427",
            "telephone_number": "936-564-6907",
            "fax_number": "936-564-0509"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "124 Creekbend Blvd",
            "address_purpose": "LOCATION",
            "city": "Nacogdoches",
            "state": "TX",
            "postal_code": "759651780",
            "country_code": "US",
            "telephone_number": "936-564-6907",
            "fax_number": "936-564-0509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROCKER",
        "first_name": "MARY",
        "credential": "CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-21",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "108844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Rebecca Crawford, COSMETOLOGIST
• Creel Physical Therapy
• Austin Matthew Creel, PT, DPT, CERT. DN
• Jesse Bryan Creel, MSN, FNP-C
• Jennifer Criss, DDS
• Crossover Counseling
• Michael Lee Crowell, PTA
• Amanda Crump, LPC
• Jeffrey C Cuevas, LPT
• Maria Bella Rita G Cuevas, PT

• Speech-Language Pathologist in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; 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.