Colleen Davis, MA CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

ASHA 12111117 Issued in MI

Practice address

977 Sexton Rd
Howell, MI 48843-8848

Phone

(248) 321-7825

NPI assigned

Sep 7, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1252281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613779200000",
    "number": "1578896767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "977 SEXTON RD",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488438848",
            "telephone_number": "248-321-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "977 SEXTON RD",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488438848",
            "telephone_number": "248-321-7825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "775 Fairway Trails Dr",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MI",
            "postal_code": "481161784",
            "country_code": "US",
            "telephone_number": "248-321-7825",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3123 Delrose St",
            "address_purpose": "LOCATION",
            "city": "Milford",
            "state": "MI",
            "postal_code": "48380",
            "country_code": "US",
            "telephone_number": "248-321-7825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "COLLEEN",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-07",
        "last_updated": "2021-02-20",
        "certification_date": "2021-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "ASHA 12111117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Howell, MI
• Providers in Howell, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2021; 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.