Individual provider Active NPI

Katherine Debutch, CCC-SLP

  • Speech-Language Pathologist
  • Jackson, MI
National Provider Identifier
1558022061
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101009364 Issued in MI
Practice address
1001 Laurence Ave Ste E
Jackson, MI 49202-2980
Phone
(517) 750-4777
NPI assigned
Jan 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Speech-Language Pathologist 235Z00000X
Speech-Language Pathologist 235Z00000X 7101009364 MI Primary

Addresses

Primary practice location

1001 Laurence Ave Ste E
Jackson, MI 49202-2980

Mailing address

1001 Laurence Ave Ste E
Jackson, MI 49202-2980
Phone (517) 750-4777

Other practice location 1

5659 Stadium Dr Ste 2
Kalamazoo, MI 49009-1932
Phone (269) 372-0436

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
7101009364MIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Speech and Therapy Center, Inc CurrentSince Mar 24, 2025 Accepting new patients
Comprehensive Speech and Therapy Center, Inc PastSince Mar 24, 2025 Accepting new patients

Locations

1001 Laurence Ave
Ste E
Jackson, MI 49202
Phone (517) 750-4777

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": "1641427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1558022061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 LAURENCE AVE STE E",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022980",
            "telephone_number": "517-750-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 LAURENCE AVE STE E",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022980",
            "telephone_number": "517-750-4777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5659 Stadium Dr Ste 2",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490091932",
            "country_code": "US",
            "telephone_number": "269-372-0436",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEBUTCH",
        "first_name": "KATHERINE",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-06",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101009364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

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