Susan Fackler
Individual provider Active NPI Speech-Language Pathologist · Brandenburg, KY
NPI 1588054589 · NPPES record last updated Mar 3, 2020
Key facts
- NPI
- 1588054589
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SLPINP00216497 (KY)
- Practice address
- 1966 Garrett Rd
Brandenburg, KY 40108-6343 - Phone
- (502) 648-7696
- NPI assigned
- Jan 28, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLPINP00216497 | KY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Capacity Care,Inc | Speech-Language Pathologist | Current |
Accepting new patients |
| Milestones Speech Therapy LLC | Speech-Language Pathologist | Current |
Accepting new patients |
Locations
4033 Taylorsville Rd
Ste 100
Louisville, KY 40220
Phone (502) 893-8414
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLPINP00216497 | KY | Yes |
Addresses
Primary practice location
1966 Garrett Rd
Brandenburg, KY 40108-6343
Mailing address
1966 Garrett Rd
Brandenburg, KY 40108-6343
Phone (502) 648-7696
Other providers in Brandenburg, KY
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- Everside Health LLC Kentucky Clinic
- Extendicare Homes, Inc.
- Eye Associates of Southern Indiana PC
- Celeste Nicole Farmer
- John Jerome Flannigan
- Susan Fleshman
- Shelby Folkerts
- Forefront Dermatology, S.C.
All providers in Brandenburg, KY · Speech-Language Pathologist in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 3, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.