Active NPI
Kristen Holleran, M.S. CCC-SLP
- Speech-Language Pathologist
- Middlebury, CT
National Provider Identifier
1386898856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 003660
- Practice address
- 778 Middlebury Rd
Middlebury, CT 06762-2401 - Phone
- (203) 758-2471
- NPI assigned
- Nov 11, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 003660 | CT | Primary |
Addresses
Primary practice location
778 Middlebury Rd
Middlebury, CT 06762-2401
Mailing address
62 Route 39 S
Sherman, CT 06784-2024
Phone (203) 733-5274
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
| License | State | Type | Specialty |
|---|---|---|---|
| 003660 | CT | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226361600000",
"number": "1386898856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "62 ROUTE 39 S",
"city": "SHERMAN",
"state": "CT",
"postal_code": "067842024",
"telephone_number": "203-733-5274"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "778 MIDDLEBURY RD",
"city": "MIDDLEBURY",
"state": "CT",
"postal_code": "067622401",
"telephone_number": "203-758-2471"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLERAN",
"first_name": "KRISTEN",
"credential": "M.S. CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-11",
"last_updated": "2008-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CT",
"license": "003660",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middlebury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.