Crislip Speech Therapy, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2004010998 Issued in MO

Legal business name

CRISLIP SPEECH THERAPY, LLC

Doing business as

Crislip Speech Therapy

Practice address

710 Abbottsford CT
Lake St Louis, MO 63367-2553

Phone

(314) 479-0306

NPI assigned

Mar 17, 2009

Last updated

Jun 2, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Andrea Lynne Crislip, M.A. CCC-SLP

Title

Owner/Speech-Language Pathologist

Phone

(314) 479-0306

Specialties & licenses 1

Addresses

Other names 1

• Crislip Speech Therapy Doing business as

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

{
    "created_epoch": "1237248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401667200000",
    "number": "1508007857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 ABBOTTSFORD CT",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633672553",
            "telephone_number": "314-479-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 ABBOTTSFORD CT",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633672553",
            "telephone_number": "314-479-0306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRISLIP SPEECH THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-17",
        "last_updated": "2014-06-02",
        "status": "A",
        "authorized_official_last_name": "CRISLIP",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "OWNER/SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "314-479-0306",
        "authorized_official_credential": "M.A. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2004010998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crislip Speech Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Speech-Language Pathologist in Lake St Louis, MO
• Providers in Lake St Louis, MO by specialty
• Speech-Language Pathologist in Missouri

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