NPIMap

Organization Active NPI

Childrens Communication Corner Inc

  • Speech-Language Pathologist
  • Seattle, WA
National Provider Identifier
1508829052
Registry record updated Mar 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
LL00003194 Issued in WA
Legal business name
CHILDRENS COMMUNICATION CORNER INC
Practice address
2366 Eastlake Ave E
#307
Seattle, WA 98102
Phone
(206) 371-9133
Fax
(206) 524-9836
NPI assigned
Apr 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2015

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

Authorized official

Name
Ms. Shana L Kelly, MS CCC SLPNPI 1235277997
Title
Owner/SLP
Phone
(206) 299-1780

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X LL00003194 WA Primary

Addresses

Primary practice location

2366 Eastlake Ave E
#307
Seattle, WA 98102

Mailing address

4115 University Way NE,
Ste 202
Seattle, WA 98105
Phone (206) 299-1780

Other identifiers 2

IdentifierTypeStateIssuer
7115272MedicaidWA
6704KEOtherWAREGENCE BLUE SHIELD OF WA

Other names 1

  • Shana Kelly MD CCC-SLP Former legal business name

National Provider Directory

National Provider Directory

Locations

4115 University Way NE
Ste 202
Seattle, WA 98105
Phone (206) 299-1780

2366 Eastlake Ave E
Ste 307
Seattle, WA 98102
Phone (206) 371-9133

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425254400000",
    "number": "1508829052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4115 UNIVERSITY WAY NE,",
            "address_2": "STE 202",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98105",
            "telephone_number": "206-299-1780",
            "fax_number": "206-524-9836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2366 EASTLAKE AVE E",
            "address_2": "#307",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98102",
            "telephone_number": "206-371-9133",
            "fax_number": "206-524-9836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDRENS COMMUNICATION CORNER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-07",
        "last_updated": "2015-03-02",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "SHANA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/SLP",
        "authorized_official_telephone_number": "206-299-1780",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS CCC SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL00003194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7115272",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD OF WA",
            "identifier": "6704KE",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shana Kelly MD CCC-SLP",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2015; 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.