NPIMap

Organization Active NPI

Speech Therapy Associates of Northwest Wisconsin, LTD

  • Speech-Language Pathologist
  • Ladysmith, WI
National Provider Identifier
1487620837
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1112-154 Issued in WI
Legal business name
SPEECH THERAPY ASSOCIATES OF NORTHWEST WISCONSIN, LTD
Practice address
900 College Ave W
Ladysmith, WI 54848-2116
Phone
(715) 532-5561
Fax
(715) 532-5146
NPI assigned
Feb 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Becky L Lundeen, MAT/CCC/SLP
Title
Owner
Phone
(715) 859-6670

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 1112-154 WI Primary

Addresses

Primary practice location

900 College Ave W
Ladysmith, WI 54848-2116

Mailing address

2523 14 3/4 Ave
Rice Lake, WI 54868-8736
Phone (715) 859-6670

Other identifiers 1

IdentifierTypeStateIssuer
42551300MedicaidWI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487620837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2523 14 3/4 AVE",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548688736",
            "telephone_number": "715-859-6670",
            "fax_number": "715-859-6669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 COLLEGE AVE W",
            "city": "LADYSMITH",
            "state": "WI",
            "postal_code": "548482116",
            "telephone_number": "715-532-5561",
            "fax_number": "715-532-5146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEECH THERAPY ASSOCIATES OF NORTHWEST WISCONSIN, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LUNDEEN",
        "authorized_official_first_name": "BECKY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-859-6670",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MAT/CCC/SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "1112-154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42551300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ladysmith, WI

Sources for this page

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