Individual provider Active NPI

Holly Eileen Stacho

  • Speech-Language Pathologist
  • Chagrin Falls, OH
National Provider Identifier
1497596860
Registry record updated Jun 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP.15791 Issued in OH
Practice address
16695 Chillicothe Rd
Chagrin Falls, OH 44023-4578
Phone
(440) 543-4221
NPI assigned
Jun 1, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP.15791 OH Primary

Addresses

Primary practice location

16695 Chillicothe Rd
Chagrin Falls, OH 44023-4578

Mailing address

8572 E Craig Dr
Chagrin Falls, OH 44023-4330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SP.15791OHMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1717200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717200000000",
    "number": "1497596860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8572 E CRAIG DR",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440234330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16695 CHILLICOTHE RD",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440234578",
            "telephone_number": "440-543-4221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACHO",
        "first_name": "HOLLY",
        "middle_name": "EILEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-01",
        "last_updated": "2024-06-01",
        "certification_date": "2024-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.15791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chagrin Falls, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2024; 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.