Speech Pathology Group LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

SPEECH PATHOLOGY GROUP LLC

Practice address

100 Beard Sawmill Rd Ste 282
Shelton, CT 06484-6175

Phone

(475) 239-5512

Fax

(203) 888-0352

NPI assigned

Jul 16, 2020

Organization subpart

No

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

Authorized official

Name

Mrs. Jennifer Samorajczyk

Title

Billing/Office

Phone

(475) 239-5512

Specialties & licenses 3

Addresses

Other identifiers 1

Tax ID family

Speech Pathology Group LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Speech Pathology Group LLC

  • Speech-Language Pathologist
  • Shelton, CT
  • NPI 1639555881
  NPD tax ID

Practitioners 2

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

• Jillian Ingrid Ball, OTR/L

  • Occupational Therapist
  • Shelton, CT
  • NPI 1568089001
  NPD
• Rachel I Criscuolo, SLP

  • Speech-Language Pathologist
  • Shelton, CT
  • NPI 1922121862
  NPD

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

{
    "created_epoch": "1594857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597190400000",
    "number": "1467060459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BEARD SAWMILL RD STE 282",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064846175",
            "telephone_number": "475-239-5512",
            "fax_number": "203-888-0352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BEARD SAWMILL RD STE 282",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064846175",
            "telephone_number": "475-239-5512",
            "fax_number": "203-888-0352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEECH PATHOLOGY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-16",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A",
        "authorized_official_last_name": "SAMORAJCZYK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "BILLING/OFFICE",
        "authorized_official_telephone_number": "475-239-5512",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1639555881",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aliyah Chantal Soto
• Melissa Soto, CRNA
• Natasha Deabreu Sousa, MS., CCC-SLP
• Suzanne Spak, OTR
• Specialized Treatment Services, LLC
• Speech Pathology Group LLC
• Brian Lee Sperling, D.O.
• SPH Enterprise LLC
• Spine Wave, Inc.
• Elizabeth Ann Spinelli, RPT

• Speech-Language Pathologist in Shelton, CT
• Providers in Shelton, CT by specialty
• Speech-Language Pathologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; 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.