Active NPI
Samantha Brush, MA, CCC-SLP
- Speech-Language Pathologist
- Detroit, MI
National Provider Identifier
1578799607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 5447 Woodward Ave
Detroit, MI 48202-4009 - Phone
- (313) 832-1100
- Fax
- (313) 578-4520
- NPI assigned
- Jun 3, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | Primary |
Addresses
Primary practice location
5447 Woodward Ave
Detroit, MI 48202-4009
Mailing address
5447 Woodward Ave
Detroit, MI 48202-4009
Phone (313) 832-1100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09135442 | Other | NATIONAL SPEECH AND LANGUAGE CERTIFICATION |
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)
- Enrolled
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243987200000",
"number": "1578799607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5447 WOODWARD AVE",
"city": "DETROIT",
"state": "MI",
"postal_code": "482024009",
"telephone_number": "313-832-1100",
"fax_number": "313-578-4520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5447 WOODWARD AVE",
"city": "DETROIT",
"state": "MI",
"postal_code": "482024009",
"telephone_number": "313-832-1100",
"fax_number": "313-578-4520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUSH",
"first_name": "SAMANTHA",
"name_prefix": "Ms.",
"credential": "MA, CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-06-03",
"last_updated": "2009-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL SPEECH AND LANGUAGE CERTIFICATION",
"identifier": "09135442",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.