Individual provider Active NPI

Molly Ann Tessin

  • Speech-Language Pathologist
  • Saint Louis, MO
National Provider Identifier
1619581410
Registry record updated Aug 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2020015995 Issued in MO
Practice address
5910 Clifton Ave
Saint Louis, MO 63109-3407
Phone
(314) 352-1043
NPI assigned
Aug 31, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2020

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 2020015995 MO Primary

Addresses

Primary practice location

5910 Clifton Ave
Saint Louis, MO 63109-3407

Mailing address

11960 Westline Industrial Dr Ste 201
Saint Louis, MO 63146-3209

Other practice location 1

5245 Murdoch Ave Apt B
Saint Louis, MO 63109-2950
Phone (513) 545-6030

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL tessinm95@gmail.com

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

State licenses

LicenseStateTypeSpecialty
2020015995MOMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1598832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1619581410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11960 WESTLINE INDUSTRIAL DR STE 201",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5910 CLIFTON AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631093407",
            "telephone_number": "314-352-1043"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5245 Murdoch Ave Apt B",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631092950",
            "country_code": "US",
            "telephone_number": "513-545-6030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TESSIN",
        "first_name": "MOLLY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-31",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2020015995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "tessinm95@gmail.com",
            "affiliation": "N",
            "address_1": "5245 Murdoch Ave Apt B",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631092950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.