Andie Street
Individual provider Active NPI Speech-Language Pathologist · Holden, LA
NPI 1659849263 · NPPES record last updated Aug 3, 2021
Key facts
- NPI
- 1659849263
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 7810 (LA)
- Practice address
- 33761 John Barber Rd
Holden, LA 70744-3429 - Phone
- (985) 981-1441
- NPI assigned
- Nov 13, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230516003179 | LA | Practitioner - Qualified Speech Language Pathologist | 1850757907 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7810 | LA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Strawberry Patch Pediatrics LLC | Current |
Accepting new patients | |
| Strawberry Patch Pediatrics LLC | Current |
Accepting new patients | |
| Andie B. Speech Therapy, LLC | Speech-Language Pathologist | Current |
Accepting new patients |
Locations
903 W Oak St
Amite, LA 70422
Phone (855) 869-9898
1054 SW Railroad Ave
Ponchatoula, LA 70454
Phone (855) 869-9898
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 7810 | LA | Yes |
Addresses
Primary practice location
33761 John Barber Rd
Holden, LA 70744-3429
Mailing address
33761 John Barber Rd
Holden, LA 70744-3429
Phone (985) 981-1441
Other practice location 1
1000 CM Fagan Drive
Unit C
Hammond, LA 70403
Phone (985) 402-1145 ext. 98551
Other providers in Holden, LA
- Melanie Neal
- Primary Care Providers for a Healthy Feliciana, Inc
- Quality Community Homes LLC
- Quality Community Homes LLC
- Christina Marie Seal
- Sandy Tillery
- Valerie Dawn Toole
All providers in Holden, LA · Speech-Language Pathologist in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 3, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.