Organization Active NPI

Andrea Gottlieb Ms CCC SLP Inc

  • Speech-Language Pathologist
  • Delray Beach, FL
National Provider Identifier
1578865515
Registry record updated Nov 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA5309 Issued in IL
Legal business name
ANDREA GOTTLIEB MS CCC SLP INC
Practice address
790 Andrews Ave
Aptc206
Delray Beach, FL 33483-7243
Phone
(561) 329-7434
Fax
(561) 278-6468
NPI assigned
Nov 24, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2010

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

Authorized official

Name
Andrea Gottlieb, MS CCC SLPNPI 1932336286
Title
President
Phone
(561) 329-7434

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: 193400000X SINGLE SPECIALTY GROUP 235Z00000X SA5309 IL Primary

Addresses

Primary practice location

790 Andrews Ave
Aptc206
Delray Beach, FL 33483-7243

Mailing address

790 Andrews Ave
Aptc206
Delray Beach, FL 33483-7243
Phone (561) 329-7434

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110418000183 FL Part B Supplier - Clinic/Group Practice 5395929293 Receives reassigned benefits from 1 practitioner
Practice locations: Delray Beach, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1290556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290556800000",
    "number": "1578865515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 ANDREWS AVE",
            "address_2": "APTC206",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334837243",
            "telephone_number": "561-329-7434",
            "fax_number": "561-278-6468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 ANDREWS AVE",
            "address_2": "APTC206",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334837243",
            "telephone_number": "561-329-7434",
            "fax_number": "561-278-6468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREA GOTTLIEB MS CCC SLP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-24",
        "last_updated": "2010-11-24",
        "status": "A",
        "authorized_official_last_name": "GOTTLIEB",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-329-7434",
        "authorized_official_credential": "MS CCC SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "SA5309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2010; 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.