Jenna Beaulieu, MS

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

TSLP14623 Issued in AZ

Practice address

15802 N Parkview PL
Surprise, AZ 85374-7466

Phone

(623) 876-7000

NPI assigned

Jul 20, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Dysart Unified School District

  • Local Education Agency (LEA)
  • Surprise, AZ
  • NPI 1750595369
  NPD (past)
• Dysart Unified School District

  • Local Education Agency (LEA)
  • Surpirse, AZ
  • NPI 1770625758
  NPD (past)

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

{
    "created_epoch": "1689811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1437839743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 N 145TH AVE APT 2065",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853955408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15802 N PARKVIEW PL",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853747466",
            "telephone_number": "623-876-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAULIEU",
        "first_name": "JENNA",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-20",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "TSLP14623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Surprise, AZ
• Speech-Language Pathologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; 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.