Individual provider Active NPI

Raelene Persad-Maharaj, M.A. CCC-SLP

  • Speech-Language Pathologist
  • Broadview Heights, OH
National Provider Identifier
1508265596
Registry record updated Aug 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP 9828 Issued in OH
Practice address
2801 E Royalton Rd
Broadview Heights, OH 44147-2827
Phone
(440) 584-9430
NPI assigned
Aug 15, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2014

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 9828 OH Primary

Addresses

Primary practice location

2801 E Royalton Rd
Broadview Heights, OH 44147-2827

Mailing address

2801 E Royalton Rd
Broadview Heights, OH 44147-2827
Phone (440) 584-9430

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
SP 9828OHMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1408060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408060800000",
    "number": "1508265596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 E ROYALTON RD",
            "city": "BROADVIEW HEIGHTS",
            "state": "OH",
            "postal_code": "441472827",
            "telephone_number": "440-584-9430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 E ROYALTON RD",
            "city": "BROADVIEW HEIGHTS",
            "state": "OH",
            "postal_code": "441472827",
            "telephone_number": "440-584-9430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSAD-MAHARAJ",
        "first_name": "RAELENE",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-15",
        "last_updated": "2014-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP 9828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broadview Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.