Kylie Erin Cook, MS CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Everett, PA

NPI 1619449709 · NPPES record last updated Dec 30, 2018

Key facts

NPI
1619449709
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SL014341 (PA)
Practice address
208 Pennknoll Rd
Everett, PA 15537-6940
Phone
(814) 623-3200
NPI assigned
Dec 30, 2018
Sex
Female
Sole proprietor
No

Organizations & group practices 4

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in SC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20220324001688 SC Practitioner - Qualified Speech Language Pathologist 3870988009 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SL014341PAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Tides Speech and Language L.L.C. Speech-Language Pathologist Current
since Mar 16, 2022
Accepting new patients
Benchmark Therapy, Inc Past Accepting new patients
Benchmark Therapy, Inc Past Accepting new patients
Benchmark Therapy, Inc. Past Accepting new patients

Locations

1744 Sam Rittenberg Blvd
Ste E
Charleston, SC 29407
Phone (607) 423-6613

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SL014341 PA Yes

Addresses

Primary practice location

208 Pennknoll Rd
Everett, PA 15537-6940

Mailing address

3488 Business 220
Bedford, PA 15522-1120
Phone (724) 859-4631

Other providers in Everett, PA

All providers in Everett, PA · Speech-Language Pathologist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.