Individual provider Active NPI

Caroline Liesell Mancuso, M.A. CCC-SLP

  • Speech-Language Pathologist
  • Greenwood Village, CO
National Provider Identifier
1376980201
Registry record updated Jun 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
STATE LICENSE PENDIN Issued in CO
Practice address
5347 S Valentia Way
Suite 120
Greenwood Village, CO 80111-3107
Phone
(720) 253-7985
NPI assigned
Jun 2, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2013

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 STATE LICENSE PENDIN CO Primary

Addresses

Primary practice location

5347 S Valentia Way
Suite 120
Greenwood Village, CO 80111-3107

Mailing address

9659 Moss Rose Cir
Highlands Ranch, CO 80129-6437
Phone (720) 253-7985

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 Arts

State licenses

LicenseStateTypeSpecialty
STATE LICENSE PENDINCOMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Alinement Therapy Inc Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1370131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370131200000",
    "number": "1376980201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9659 MOSS ROSE CIR",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801296437",
            "telephone_number": "720-253-7985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5347 S VALENTIA WAY",
            "address_2": "SUITE 120",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801113107",
            "telephone_number": "720-253-7985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCUSO",
        "first_name": "CAROLINE",
        "middle_name": "LIESELL",
        "name_prefix": "Mrs.",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-02",
        "last_updated": "2013-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "STATE LICENSE PENDIN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood Village, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2013; 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.