Individual provider Active NPI

Sosena Demissie Melese, SLP

  • Speech-Language Pathologist
  • Columbia, MD
National Provider Identifier
1508749979
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
03090L Issued in MD
Practice address
8840 Stanford Blvd Ste 1900
Columbia, MD 21045-5910
Phone
(410) 404-9713
Fax
(210) 568-4123
NPI assigned
Jul 31, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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 03090L MD Primary

Addresses

Primary practice location

8840 Stanford Blvd Ste 1900
Columbia, MD 21045-5910

Mailing address

7930 Pettigrew St
Elkridge, MD 21075-7957
Phone (301) 605-3816

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
03090LMDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mar Pediatric Therapy LLC Speech-Language Pathologist PastSince Aug 3, 2025 Accepting new patients

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": "1753920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1508749979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7930 PETTIGREW ST",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210757957",
            "telephone_number": "301-605-3816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8840 STANFORD BLVD STE 1900",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210455910",
            "telephone_number": "410-404-9713",
            "fax_number": "210-568-4123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELESE",
        "first_name": "SOSENA",
        "middle_name": "DEMISSIE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-31",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "03090L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2025; 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.