Ivanisse Coraly Asencio-Acevedo, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL60846550 Issued in WA

Practice address

1502 S Orchard St Apt F304
Tacoma, WA 98465-2445

Phone

(334) 470-6604

NPI assigned

Feb 8, 2025

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

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.

• Hona Medical Group PA

  • Speech-Language Pathologist
  • Miami, FL
  • NPI 1487490553

  WA

  Medicare reassignment NPD

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

{
    "created_epoch": "1738972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1669287579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 S ORCHARD ST APT F304",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984652445",
            "telephone_number": "334-470-6604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 S ORCHARD ST APT F304",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984652445",
            "telephone_number": "334-470-6604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASENCIO-ACEVEDO",
        "first_name": "IVANISSE",
        "middle_name": "CORALY",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-08",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL60846550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lee Eric Artman, M. D.
• Liliya Artym
• Anne M Asam, M.D.
• Shirley Asare-Nkansah
• Michelangelo Villanueva Ascalon, RDH
• Alfred Ogwago Aseto, CBT
• Lauren Ashbaugh
• Emilee Ashby, CRNA
• Savanna Ashby
• Ashley Dialysis

• Speech-Language Pathologist in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Speech-Language Pathologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; 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.