Active NPI
Kristen Lee Desjardins, M.S., CCC-SLP
- Speech-Language Pathologist
- Dallas, TX
National Provider Identifier
1609215300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 105140
- Practice address
- 8610 Southwestern Blvd
Apt 1502
Dallas, TX 75206-2600 - Phone
- (512) 970-8714
- NPI assigned
- Jun 17, 2013
- Sex
- Female
- Sole proprietor
- No
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 | 105140 | TX | Primary |
Addresses
Primary practice location
8610 Southwestern Blvd
Apt 1502
Dallas, TX 75206-2600
Mailing address
8610 Southwestern Blvd
Apt 1502
Dallas, TX 75206-2600
Phone (512) 970-8714
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)
- Not enrolled
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371772800000",
"number": "1609215300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8610 SOUTHWESTERN BLVD",
"address_2": "APT 1502",
"city": "DALLAS",
"state": "TX",
"postal_code": "752062600",
"telephone_number": "512-970-8714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8610 SOUTHWESTERN BLVD",
"address_2": "APT 1502",
"city": "DALLAS",
"state": "TX",
"postal_code": "752062600",
"telephone_number": "512-970-8714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESJARDINS",
"first_name": "KRISTEN",
"middle_name": "LEE",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-17",
"last_updated": "2013-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "105140",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.