Individual provider Active NPI

Alicia Lynne Dabek

  • Speech-Language Pathologist
  • Waltham, MA
National Provider Identifier
1386026912
Registry record updated Jun 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
S72144441 Issued in MA
Practice address
465 Waverley Oaks Rd
Suite 101
Waltham, MA 02452-8438
Phone
(781) 894-6564
NPI assigned
Jun 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2015

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 S72144441 MA Primary

Addresses

Primary practice location

465 Waverley Oaks Rd
Suite 101
Waltham, MA 02452-8438

Mailing address

1572 Commonwealth Ave Apt 101
Brighton, MA 02135-5023
Phone (860) 817-5706

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

State licenses

LicenseStateTypeSpecialty
S72144441MAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434672000000",
    "number": "1386026912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1572 COMMONWEALTH AVE APT 101",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021355023",
            "telephone_number": "860-817-5706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 WAVERLEY OAKS RD",
            "address_2": "SUITE 101",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024528438",
            "telephone_number": "781-894-6564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DABEK",
        "first_name": "ALICIA",
        "middle_name": "LYNNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-19",
        "last_updated": "2015-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "S72144441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2015; 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.