Mary Elizabeth Avery, MS, CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Crestwood, KY

NPI 1386952166 · NPPES record last updated Jul 8, 2020

Key facts

NPI
1386952166
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
3806 (KY)
Practice address
6317 Highway 329
Crestwood, KY 40014-9040
Phone
(502) 384-0910
NPI assigned
Sep 15, 2010
Sex
Female
Sole proprietor
No

Organizations & group practices 3

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
3806KYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ascb Therapy LLC Speech-Language Pathologist Past
since Apr 19, 2020
Accepting new patients
Julie Murray Inc/Chatter Box Past
since Jul 12, 2020
Accepting new patients
The Chatter Box LLC Speech-Language Pathologist Past
since Jul 12, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 3806 KY Yes

Addresses

Primary practice location

6317 Highway 329
Crestwood, KY 40014-9040

Mailing address

4515 Timothy Way
Crestwood, KY 40014-9161
Phone (502) 797-9681

Other practice location 1

4603 Timberwalk Ct
LA Grange, KY 40031-6746
Phone (703) 575-8129

Other names

  • Mary Beth Russell Other name

Other providers in Crestwood, KY

All providers in Crestwood, KY · Speech-Language Pathologist in Kentucky

Sources for this page

Verify at the official NPI Registry.