Stacie Marie Provosty, M.A. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

5819 Issued in LA

Practice address

3419 Saint Claude Ave
New Orleans, LA 70117-6144

Phone

(504) 330-8160

NPI assigned

Sep 14, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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": "1189728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189728000000",
    "number": "1447445259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2833 JOSEPH ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701157043",
            "telephone_number": "504-864-8311",
            "fax_number": "504-864-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3419 SAINT CLAUDE AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701176144",
            "telephone_number": "504-330-8160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVOSTY",
        "first_name": "STACIE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-14",
        "last_updated": "2007-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "LA",
            "license": "5819",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "8000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Provenzano
• Providence Community Housing
• Gail Jones Provost
• Leticia Provost, L.C.S.W.
• Emily Provosty
• Amy Victoria Prudhomme, D.O.
• Derrick Pruitt, B.S PSYCHOLOGY
• Kristen Pruitt, D.O.
• Karen L. Pryor, NP
• Prytania Pathology Associates LLC

• Speech-Language Pathologist in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Speech-Language Pathologist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2007; 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.