Amy Lynn Balent, M.S., CCC-SLP/L,CBIS

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SL009685 Issued in PA

Practice address

68 Oak Dr
Dallas, PA 18612-2949

Phone

(570) 709-1215

NPI assigned

Mar 30, 2010

Sex

Female

Sole proprietor

Yes

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

Enrolled in PA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Well-Nurtured Development

  • Pediatric Occupational Therapist
  • Kingston, PA
  • NPI 1952994659

  Speech-Language Pathologist

  Medicare reassignment NPD

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

{
    "created_epoch": "1269907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644019200000",
    "number": "1487979605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 OAK DR",
            "city": "DALLAS",
            "state": "PA",
            "postal_code": "186122949",
            "telephone_number": "570-709-1215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 OAK DR",
            "city": "DALLAS",
            "state": "PA",
            "postal_code": "186122949",
            "telephone_number": "570-709-1215"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "933 Apple Tree Rd",
            "address_purpose": "LOCATION",
            "city": "Harding",
            "state": "PA",
            "postal_code": "186437038",
            "country_code": "US",
            "telephone_number": "570-336-0309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALENT",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "credential": "M.S., CCC-SLP/L,CBIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-30",
        "last_updated": "2022-02-05",
        "certification_date": "2022-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL009685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Dallas, PA
• Providers in Dallas, PA by specialty
• Speech-Language Pathologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.