Individual provider Active NPI

Jillyan Leigh Stlaurent, M.A. CCC-SLP

  • Speech-Language Pathologist
  • Orlando, FL
National Provider Identifier
1639557697
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA12459 Issued in FL
Practice address
111 N Orange Ave Ste 800
Orlando, FL 32801-2381
Phone
(512) 399-0064
NPI assigned
May 11, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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 SA12459 FL Primary

Addresses

Primary practice location

111 N Orange Ave Ste 800
Orlando, FL 32801-2381

Mailing address

132 Lagoon Rd
Winter Haven, FL 33884-2527

Other practice location 1

132 Lagoon Rd
Winter Haven, FL 33884-2527
Phone (863) 287-3026

Other practice location 2

1997 Annapolis Exchange Pkwy Ste 300
Annapolis, MD 21401-3273
Phone (512) 399-0064

Other practice location 3

40 Burton Hills Blvd Ste 200
Nashville, TN 37215-5902
Phone (512) 399-0064

Other practice location 4

300 Baker Ave Ste 300
Concord, MA 01742-2124
Phone (512) 399-0064

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, FL, MD, MA, MS5 enrollments

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20230526002052 TN Practitioner - Qualified Speech Language Pathologist 0042677569 Reassigns benefits to 1 organization
I20230531000795 FL Practitioner - Qualified Speech Language Pathologist 0042677569 Reassigns benefits to 1 organization
I20230605002666 MD Practitioner - Qualified Speech Language Pathologist 0042677569 Reassigns benefits to 1 organization
I20230719002367 MA Practitioner - Qualified Speech Language Pathologist 0042677569 Reassigns benefits to 1 organization
I20231212000801 MS Practitioner - Qualified Speech Language Pathologist 0042677569 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
7108TNMDPhysical Therapy Assistant
SA12459FLMDSpeech-Language Pathologist
07843MDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Expressable Speech-Language Pathology, P.C. Speech-Language Pathologist CurrentSince Jul 17, 2023 Accepting new patients
Expressable Therapy PC Speech-Language Pathologist CurrentSince Jul 17, 2023 Accepting new patients

Locations

633 W 5th St
Ofc 2876B
Los Angeles, CA 90071

111 N Orange Ave
Ste 800
Orlando, FL 32801
Phone (212) 287-4257

300 Baker Ave
Ste 300
Concord, MA 01742
Phone (864) 336-2731

1997 Annapolis Exchange Pkwy
Ste 300
Annapolis, MD 21401
Phone (410) 261-6439

232 Market St
Jackson, MS 39232
Phone (588) 498-6767

40 Burton Hills Blvd
Ste 200
Nashville, TN 37215
Phone (615) 257-8410

7600 Chevy Chase Dr
Ste 300
Austin, TX 78752
Phone (512) 318-2503

Organizations & group practices 2

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": "1431302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1639557697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 LAGOON RD",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338842527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N ORANGE AVE STE 800",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328012381",
            "telephone_number": "512-399-0064"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "132 Lagoon Rd",
            "address_purpose": "LOCATION",
            "city": "Winter Haven",
            "state": "FL",
            "postal_code": "338842527",
            "country_code": "US",
            "telephone_number": "863-287-3026",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1997 Annapolis Exchange Pkwy Ste 300",
            "address_purpose": "LOCATION",
            "city": "Annapolis",
            "state": "MD",
            "postal_code": "214013273",
            "country_code": "US",
            "telephone_number": "512-399-0064",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "40 Burton Hills Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372155902",
            "country_code": "US",
            "telephone_number": "512-399-0064",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Baker Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "MA",
            "postal_code": "017422124",
            "country_code": "US",
            "telephone_number": "512-399-0064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STLAURENT",
        "first_name": "JILLYAN",
        "middle_name": "LEIGH",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-11",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA12459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.