Individual provider Active NPI

Alyssa Haney, CF-SLP

  • Speech-Language Pathologist
  • Saint Charles, MO
National Provider Identifier
1629646187
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2021019675 Issued in MO
Practice address
1552 Country Club Plaza Dr Unit 1570
Saint Charles, MO 63303-3859
Phone
(636) 724-1127
NPI assigned
Jun 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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 2021019675 MO Primary

Addresses

Primary practice location

1552 Country Club Plaza Dr Unit 1570
Saint Charles, MO 63303-3859

Mailing address

1552 Country Club Plaza Dr
Saint Charles, MO 63303-3859

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
2021019675MOMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Select Rehab St Louis LLC PastSince Jun 15, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1623369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1629646187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1552 COUNTRY CLUB PLAZA DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633033859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1552 COUNTRY CLUB PLAZA DR UNIT 1570",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633033859",
            "telephone_number": "636-724-1127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANEY",
        "first_name": "ALYSSA",
        "credential": "CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-11",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2021019675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; 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.