Berkley Kids Rehab – Speech-Language Pathologist

Key facts

NPI: 1447093869
Entity type: Organization (NPI type 2)
Primary specialty: Speech-Language Pathologist 235Z00000X
Legal business name: BERKLEY KIDS REHAB
Practice address: 25595 Coolidge Hwy
Oak Park, MI 48237-1306
Phone: (248) 629-4696
NPI assigned: Jun 13, 2024
Organization subpart: No

Authorized official

Name: Molly Evans
Title: Owner/Director
Phone: (248) 629-4696

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Maureen Elizabeth Mattiello, PT Physical Therapist · Farmington Hills, MI · NPI 1932421245

Medicare reassignment NPD MI
Brittany Marie McLean Speech-Language Pathologist · Sterling Heights, MI · NPI 1740771294

Medicare reassignment NPD MI · SPEECH-LANGUAGE PATHOLOGIST
Kerri Sills Occupational Therapist · Waterford, MI · NPI 1417495425

Medicare reassignment NPD MI
Amber Breana Stephens, PT, DPT Physical Therapist · Commerce Township, MI · NPI 1164246195

Medicare reassignment NPD MI
Ruby Ronesse Dockery- Boykin, OTD Pediatric Occupational Therapist · Saint Clair Shores, MI · NPI 1922547173

Medicare reassignment MI
Chelsea Marie Klaska, OTRL Occupational Therapist · Bingham Farms, MI · NPI 1184115982

NPD OCCUPATIONAL THERAPIST

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MI

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20250121001611	MI	Part B Supplier - Clinic/Group Practice	2567991581	Receives reassigned benefits from 5 practitioners Practice locations: Oak Park, MI

National Provider Directory

Locations

25595 Coolidge Hwy
Oak Park, MI 48237
Phone (248) 629-4696

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Occupational Therapist Group: 193200000X MULTI-SPECIALTY GROUP	225X00000X
Speech-Language Pathologist Group: 193200000X MULTI-SPECIALTY GROUP	235Z00000X			Yes

Addresses

Primary practice location

25595 Coolidge Hwy
Oak Park, MI 48237-1306

Mailing address

25595 Coolidge Hwy
Oak Park, MI 48237-1306
Phone (248) 629-4696

Other providers in Oak Park, MI

All providers in Oak Park, MI · Speech-Language Pathologist in Michigan

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.