Individual provider Active NPI

Stefanie Mathis, MS, CCC-SLP

  • Speech-Language Pathologist
  • Phoenix, AZ
National Provider Identifier
1417357500
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP9028 Issued in AZ
Practice address
4510 N 37TH Ave
Phoenix, AZ 85019-3206
Phone
(623) 217-0033
NPI assigned
Aug 26, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

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 SLP9028 AZ Primary

Addresses

Primary practice location

4510 N 37TH Ave
Phoenix, AZ 85019-3206

Mailing address

5810 N 49TH Ave
Glendale, AZ 85301-6222
Phone (623) 842-3889

Other practice location 1

6859 E Rembrandt Ave Ste 101
Mesa, AZ 85212-3629
Phone (480) 389-4516

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

LicenseStateTypeSpecialty
SLP9028AZMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1417357500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5810 N 49TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853016222",
            "telephone_number": "623-842-3889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 N 37TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850193206",
            "telephone_number": "623-217-0033"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6859 E Rembrandt Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852123629",
            "country_code": "US",
            "telephone_number": "480-389-4516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "STEFANIE",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-26",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP9028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2026; 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.