Traci A Smallwood, MA CCC SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LICC-247 Issued in MN

Practice address

15600 36TH Ave N Ste 120
Plymouth, MN 55446-3687

Phone

(763) 595-0812

Fax

(763) 595-0824

NPI assigned

Apr 10, 2007

Last updated

Sep 22, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Minnetonka Pediatric Therapy Center, LLC

  • Speech-Language Pathologist
  • Plymouth, MN
  • NPI 1891998035
  Medicare reassignment

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1609099647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15600 36TH AVE N STE 120",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554463687",
            "telephone_number": "763-595-0812",
            "fax_number": "763-595-0824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15600 36TH AVE N STE 120",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554463687",
            "telephone_number": "763-595-0812",
            "fax_number": "763-595-0824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALLWOOD",
        "first_name": "TRACI",
        "middle_name": "A",
        "credential": "MA CCC SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "LICC-247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lily Lucille Marie Skorseth
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• Kathryne E Slavics, M.A.
• Madeline Slind
• Nancy Rains Slothower, PHD
• Smile Design Dentistry, PLLC
• Megan Smith-Cannistraci, PT
• Anna C Smith, MA LADC
• Annalyn Smith, M.A, CCC-SLP
• Gina Smith

• Speech-Language Pathologist in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Speech-Language Pathologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2025; 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.