Emily Irene Goudreault, M.A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7101005049 Issued in MI

Practice address

291 W Lakewood Blvd Ste H
Holland, MI 49424-1969

Phone

(970) 988-6718

NPI assigned

Aug 24, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Emily Irene Folsom Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1417676263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5904 PRESERVATION DR",
            "city": "HAMILTON",
            "state": "MI",
            "postal_code": "494199693",
            "telephone_number": "970-988-6718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 W LAKEWOOD BLVD STE H",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494241969",
            "telephone_number": "970-988-6718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUDREAULT",
        "first_name": "EMILY",
        "middle_name": "IRENE",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-24",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101005049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "FOLSOM",
            "middle_name": "IRENE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mary Joy Gootjes, M.D.
• Charity Gorbach, LMSW, CAADC
• Daniel Bryan Gordon, D.D.S.
• Kelly Gotberg, PT, DPT
• Rachel K Goudie, PT
• Lindsay Gould
• Jael Martha Govea
• Danielle Govert
• Thomas Wayne Grabill, LLMFT
• Ramona Ioana Grad, PH.D., LPC

• Speech-Language Pathologist in Holland, MI
• Providers in Holland, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; 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.