Individual provider Active NPI

Andreana Marella Hendrickson, SLP

  • Speech-Language Pathologist
  • Broadview HTS, OH
National Provider Identifier
1386952208
Registry record updated Jan 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP 10157 Issued in OH
Practice address
1929 E Royalton Rd Ste a
Broadview HTS, OH 44147-2868
Phone
(440) 838-0990
Fax
(440) 838-8440
NPI assigned
Sep 14, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2012

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 SP 10157 OH Primary

Addresses

Primary practice location

1929 E Royalton Rd Ste a
Broadview HTS, OH 44147-2868

Mailing address

1929 E Royalton Rd Ste a
Broadview HTS, OH 44147-2868
Phone (440) 838-0990

Other identifiers 1

IdentifierTypeStateIssuer
0849916MedicaidOH

Other names 1

  • Miss Andreana Marella Somich Former name

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
SP 10157OHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Easter Seals Northern Ohio Speech-Language Pathologist Past Accepting new patients
Easter Seals Northern Ohio Past Accepting new patients

Organizations & group practices 2

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": "1284422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1386952208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1929 E ROYALTON RD STE A",
            "city": "BROADVIEW HTS",
            "state": "OH",
            "postal_code": "441472868",
            "telephone_number": "440-838-0990",
            "fax_number": "440-838-8440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1929 E ROYALTON RD STE A",
            "city": "BROADVIEW HTS",
            "state": "OH",
            "postal_code": "441472868",
            "telephone_number": "440-838-0990",
            "fax_number": "440-838-8440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKSON",
        "first_name": "ANDREANA",
        "middle_name": "MARELLA",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-14",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP 10157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0849916",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREANA",
            "last_name": "SOMICH",
            "middle_name": "MARELLA",
            "prefix": "MISS",
            "credential": "SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Broadview HTS, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2012; 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.