Rebecca Bourque Miller, CCC-SLP, CLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

8312 Issued in LA

Practice address

8300 Constantin Blvd
Baton Rouge, LA 70809-3489

Phone

(225) 374-1520

NPI assigned

Jul 9, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Rebecca Marie Bourque Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Thriving Littles Pediatric Therapy L.L.C

  • Speech-Language Pathologist
  • Baton Rouge, LA
  • NPI 1366139958

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1531094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650844800000",
    "number": "1457847857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1344 GENTLE WIND DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708202919",
            "telephone_number": "225-276-0347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 CONSTANTIN BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093489",
            "telephone_number": "225-374-1520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8415 Goodwood Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708067851",
            "country_code": "US",
            "telephone_number": "225-765-6346",
            "fax_number": "225-765-8585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "REBECCA",
        "middle_name": "BOURQUE",
        "credential": "CCC-SLP, CLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-09",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "114646",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "LA",
            "license": "8312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "BOURQUE",
            "middle_name": "MARIE",
            "credential": "SLP-CFY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Melissa Miller, LMT
• Michelle Miller
• Morgan Ashlie Miller, CRNA
• Muriel Kay Miller, R.N.
• Peyton Hollis Miller
• Reygan Miller, MCD CCC-SLP
• Rosamond Grace Miller, PA
• Russell J Miller, LCSW
• Sheryl Hope Miller, LCSW-BACS
• Susan Miller, BCBA, LBA

• Speech-Language Pathologist in Baton Rouge, LA
• Providers in Baton Rouge, 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 Apr 25, 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.