Individual provider Active NPI

Lauren Keely Williams, MS CCC-SLP

  • Speech-Language Pathologist
  • Glendale, AZ
National Provider Identifier
1538440987
Registry record updated Feb 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
14113069 Issued in AZ
Practice address
4650 W Sweetwater Ave
Glendale, AZ 85304-1505
Phone
(602) 347-2826
Fax
(602) 347-2709
NPI assigned
Aug 30, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2018

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 14113069 AZ Primary

Addresses

Primary practice location

4650 W Sweetwater Ave
Glendale, AZ 85304-1505

Mailing address

4650 W Sweetwater Ave
Glendale, AZ 85304-1505
Phone (602) 347-2826

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191205001186 AZ Practitioner - Qualified Speech Language Pathologist 8224461231 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
14113069AZMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Theraplay4Kidz, LLC Speech-Language Pathologist CurrentSince Oct 15, 2019 Accepting new patients
Achievement Therapy Services Past Accepting new patients

Locations

530 E McDowell Rd
Ste 107495
Phoenix, AZ 85004

9525 E Doubletree Ranch Rd
Ste 101
Scottsdale, AZ 85258
Phone (480) 488-3946

Organizations & group practices 2

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": "1314662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518048000000",
    "number": "1538440987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 W SWEETWATER AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853041505",
            "telephone_number": "602-347-2826",
            "fax_number": "602-347-2709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W SWEETWATER AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853041505",
            "telephone_number": "602-347-2826",
            "fax_number": "602-347-2709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "LAUREN",
        "middle_name": "KEELY",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-30",
        "last_updated": "2018-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "14113069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.