Individual provider Active NPI

Nikita Rae Williamson, M.S., SLP-CF

  • Speech-Language Pathologist
  • Mesa, AZ
National Provider Identifier
1609788629
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
TSLP17931 Issued in AZ
Practice address
4824 E Baseline Rd Ste 124
Mesa, AZ 85206-4679
Phone
(480) 389-6749
NPI assigned
Sep 22, 2026
Last updated
Sep 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X TSLP17931 AZ Primary

Addresses

Primary practice location

4824 E Baseline Rd Ste 124
Mesa, AZ 85206-4679

Mailing address

4824 E Baseline Rd Ste 124
Mesa, AZ 85206-4679
Phone (480) 389-6749

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1609788629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4824 E BASELINE RD STE 124",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064679",
            "telephone_number": "480-389-6749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4824 E BASELINE RD STE 124",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064679",
            "telephone_number": "480-389-6749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "NIKITA",
        "middle_name": "RAE",
        "credential": "M.S., SLP-CF",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-22",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "TSLP17931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.