Mallory Elise Abercrombie

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA20932 Issued in FL

Practice address

95 Tavernier Dr
Ponte Vedra, FL 32081-0676

Phone

(904) 729-6759

NPI assigned

Dec 2, 2022

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Lively Speech and Language Therapy, LLC

  • Speech-Language Pathologist
  • St Augustine, FL
  • NPI 1912614488
  NPD
• Honey Pediatric Behavioral Health LLC

  • Behavior Analyst
  • St Augustine, FL
  • NPI 1932980521
  NPD (past)

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

{
    "created_epoch": "1669939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1487364162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7279 SAN PEDRO RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322173407",
            "telephone_number": "904-238-9830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 TAVERNIER DR",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320810676",
            "telephone_number": "904-729-6759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABERCROMBIE",
        "first_name": "MALLORY",
        "middle_name": "ELISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-02",
        "last_updated": "2022-12-02",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA20932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Mallory@livelyslp.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "work email",
            "address_1": "95 Tavernier Dr",
            "city": "Ponte Vedra",
            "state": "FL",
            "country_code": "US",
            "postal_code": "320810676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• 4Ecode, LLC D.B.a. Me Squared Connects
• A Loving Hand Home Care LLC
• Christina Stough Adams, MD
• Sarah Crane Adams, MD
• Adrian and Becky Home Health Inc
• Aegis Group Practice, LLC
• Affordable Chiropractic Medicine US 1

• Speech-Language Pathologist in Ponte Vedra, FL
• Providers in Ponte Vedra, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.