Individual provider Active NPI

Catherine L Carrara-O'Brien, MS, CCC-SLP/L

  • Speech-Language Pathologist
  • Peoria, IL
National Provider Identifier
1376027342
Registry record updated Sep 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.001636 Issued in IL
Practice address
800 W Romeo B Garrett Ave
Peoria, IL 61605-2207
Phone
(309) 672-6810
Fax
(309) 676-9831
NPI assigned
Sep 17, 2018
Last updated
Sep 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2018

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 146.001636 IL Primary

Addresses

Primary practice location

800 W Romeo B Garrett Ave
Peoria, IL 61605-2207

Mailing address

9020 W Schmitt LN
Edwards, IL 61528-9537
Phone (309) 678-2156

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 Science

State licenses

LicenseStateTypeSpecialty
146.001636ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1537142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537142400000",
    "number": "1376027342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9020 W SCHMITT LN",
            "city": "EDWARDS",
            "state": "IL",
            "postal_code": "615289537",
            "telephone_number": "309-678-2156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W ROMEO B GARRETT AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616052207",
            "telephone_number": "309-672-6810",
            "fax_number": "309-676-9831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRARA-O'BRIEN",
        "first_name": "CATHERINE",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "MS, CCC-SLP/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-17",
        "last_updated": "2018-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.001636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2018; 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.