Active NPI
Alicia Livelli
- Speech-Language Pathologist
- Philadelphia, PA
National Provider Identifier
1417474560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SL012647
- Practice address
- 1332 Disston St
Philadelphia, PA 19111-4502 - Phone
- (267) 815-8544
- NPI assigned
- Aug 29, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 | SL012647 | PA | Primary |
Addresses
Primary practice location
1332 Disston St
Philadelphia, PA 19111-4502
Mailing address
339 Bainbridge St
Philadelphia, PA 19147-1547
Other practice location 1
6500 Tabor Ave
Philadelphia, PA 19111-5332
Phone (215) 697-8009
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
| License | State | Type | Specialty |
|---|---|---|---|
| SL012647 | PA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maple Leaf Behavioral Services | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Early Intervention Provider Agency
- Philadelphia, PA
- NPI 1124474697
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1417474560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "339 BAINBRIDGE ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191471547"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1332 DISSTON ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191114502",
"telephone_number": "267-815-8544"
}
],
"practiceLocations": [
{
"address_1": "6500 Tabor Ave",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191115332",
"country_code": "US",
"telephone_number": "215-697-8009",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LIVELLI",
"first_name": "ALICIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-29",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "PA",
"license": "SL012647",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.