Kelly Baierl, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

60758912 Issued in WA

Practice address

2145 Tibbetts Dr Ste a
Longview, WA 98632-4211

Phone

(360) 560-1972

NPI assigned

May 21, 2018

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Kidspace Therapy, LLC

  • Developmental Disabilities Clinic/Center
  • Longview, WA
  • NPI 1184019184
  NPD (past)
• Progress Center,Inc

  • Speech-Language Pathologist
  • Longview, WA
  • NPI 1497809636
  NPD (past)

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

{
    "created_epoch": "1526860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526860800000",
    "number": "1629569181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2145 TIBBETTS DR STE A",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986324211",
            "telephone_number": "360-560-1972",
            "fax_number": "360-703-3452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2145 TIBBETTS DR STE A",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986324211",
            "telephone_number": "360-560-1972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAIERL",
        "first_name": "KELLY",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-21",
        "last_updated": "2018-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "60758912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHA",
            "identifier": "14174246",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anita Louise Bach, RDH
• Kyle Nathan Backer, M.D.
• Hanna Badger
• Sholeh Bagheri, M.D.
• Suhail Bahu, MD
• Gerry Lee Bailey, CG 60801682
• Amanda Elaine Baker
• Nicole Layne Baker
• Sadie Baker, CNA
• Tabitha L Baldwin, SUDPT, AAC

• All providers in Longview, WA
• Speech-Language Pathologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2018; 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.