Nicole A Kocanda, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

14382786 Issued in IL

Practice address

1025 N Country Club Dr
Mesa, AZ 85201-3302

Phone

(708) 979-1588

NPI assigned

Mar 22, 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

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

{
    "created_epoch": "1679443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1457053357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7820 E BASELINE RD UNIT 112",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852095438",
            "telephone_number": "708-979-1588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 N COUNTRY CLUB DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852013302",
            "telephone_number": "708-979-1588"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11741 S Kedvale Ave",
            "address_purpose": "LOCATION",
            "city": "Alsip",
            "state": "IL",
            "postal_code": "608031729",
            "country_code": "US",
            "telephone_number": "708-979-1588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOCANDA",
        "first_name": "NICOLE",
        "middle_name": "A",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-22",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "14382786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruth A Knudtson, DC
• Addison Allen Knutson, DC
• Garrett Jarmin Kobayashi
• Gregory Koberstein, PT
• Sara Kobylinski
• Ariel Koch, LCSW
• Emily Koch, RN
• Kyle Koch, PT
• Julie Koclanis
• Mallory Kocmoud, M.S. CCC-SLP

• Speech-Language Pathologist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Speech-Language Pathologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; 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.