Kristen E Licata, M.S., CCC-SLP/L

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

242004411 Issued in IL

Practice address

6020 151St St
Oak Forest, IL 60452-1841

Phone

(708) 687-0900

NPI assigned

Jun 15, 2017

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

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.

• Southwest Cook County Cooperative Assn for Special Education

  • Local Education Agency (LEA)
  • Oak Forest, IL
  • NPI 1962680009
  NPD (past)

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

{
    "created_epoch": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1679003347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14332 WOODED PATH LN",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604622855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6020 151ST ST",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604521841",
            "telephone_number": "708-687-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICATA",
        "first_name": "KRISTEN",
        "middle_name": "E",
        "credential": "M.S., CCC-SLP/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-15",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242004411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary T Lake, SLP
• Barbara Lynn Lange, DPM
• Harrison Leibow
• Mary Rene Leonhardt
• Philip James Levoy, D.D.S.
• Lighthouse Wellness Centers
• Joanne Marie Linane, OTR/L
• Heather Lindenberg
• David Liu, PHARMD
• Mena Loka Sr.

• Speech-Language Pathologist in Oak Forest, IL
• Providers in Oak Forest, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.