Individual provider Active NPI

Nicole D'Aversa, CCC-SLP

  • Speech-Language Pathologist
  • Wilmington, DE
National Provider Identifier
1538063763
Registry record updated Oct 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
O1-0012671 Issued in DE
Practice address
16 Idella Ave
Wilmington, DE 19804-1661
Phone
(302) 552-3796
NPI assigned
Oct 2, 2026
Last updated
Oct 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SL019579 PA
Speech-Language Pathologist 235Z00000X O1-0012671 DE Primary

Addresses

Primary practice location

16 Idella Ave
Wilmington, DE 19804-1661

Mailing address

8 Colonial CT
Conshohocken, PA 19428-1286

Other practice location 1

24 Hagerty Blvd Ste 12
West Chester, PA 19382-7595
Phone (484) 630-3474

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790899200000",
    "number": "1538063763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 COLONIAL CT",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194281286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 IDELLA AVE",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198041661",
            "telephone_number": "302-552-3796"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24 Hagerty Blvd Ste 12",
            "address_purpose": "LOCATION",
            "city": "West Chester",
            "state": "PA",
            "postal_code": "193827595",
            "country_code": "US",
            "telephone_number": "484-630-3474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "D'AVERSA",
        "first_name": "NICOLE",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-02",
        "last_updated": "2026-10-02",
        "certification_date": "2026-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL019579",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "DE",
            "license": "O1-0012671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.