Individual provider Active NPI

Heather L Guernsey, SLP

  • Speech-Language Pathologist
  • Dearborn, MI
National Provider Identifier
1508510454
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101003080 Issued in MI
Practice address
2021 Monroe St
Dearborn, MI 48124-2926
Phone
(517) 245-4778
Fax
(517) 698-8223
NPI assigned
Feb 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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 7101003080 MI Primary

Addresses

Primary practice location

2021 Monroe St
Dearborn, MI 48124-2926

Mailing address

PO Box 12279
Lansing, MI 48901-2279
Phone (517) 245-4778

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
7101003080MIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Advance ABA , LLC Speech-Language Pathologist CurrentSince Sep 23, 2024 Accepting new patients

Locations

7445 Allen Rd
Ste 280
Allen Park, MI 48101
Phone (248) 569-2695

2021 Monroe St
Dearborn, MI 48124
Phone (517) 245-4777

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1644364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1508510454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12279",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489012279",
            "telephone_number": "517-245-4778",
            "fax_number": "517-698-8223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 MONROE ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242926",
            "telephone_number": "517-245-4778",
            "fax_number": "517-698-8223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERNSEY",
        "first_name": "HEATHER",
        "middle_name": "L",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-09",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101003080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; 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.