Andrea Carol Staten, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

S2354 Issued in MS

Practice address

146 Yocona Ridge Rd
Oxford, MS 38655-6904

Phone

(662) 934-9885

NPI assigned

Aug 17, 2014

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

Other names 1

• Mrs. Andrea Carol Suzyn Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Dreamcatcher Speech and Language LLC

  • Speech-Language Pathologist
  • Oxford, MS
  • NPI 1780080341
  NPD (past) Authorized official

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

{
    "created_epoch": "1408233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415577600000",
    "number": "1497154355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 YOCONA RIDGE RD",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386556904",
            "telephone_number": "662-934-9885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 YOCONA RIDGE RD",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386556904",
            "telephone_number": "662-934-9885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATEN",
        "first_name": "ANDREA",
        "middle_name": "CAROL",
        "name_prefix": "Ms.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-17",
        "last_updated": "2014-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S2354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "SUZYN",
            "middle_name": "CAROL",
            "prefix": "MRS.",
            "credential": "M.S.CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• William A Spencer, M.D.
• Jennie L Spicer, LMSW
• Martha W. Spragins, MSW
• Jamie Stacy
• Karon Louise Stanford, M.S.
• Emily Fletcher Steele, PCMHT
• Jamesha Steele, MSW, CMHT
• Khristan Steen, RN
• Carrie Elizabeth Stephens, M.S., CCC-SLP
• Benjamin Stepp, LPC

• Speech-Language Pathologist in Oxford, MS
• Providers in Oxford, MS by specialty
• Speech-Language Pathologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2014; 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.