Amy Nicole Beelen, MS CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SL005882L Issued in PA

Practice address

900 Willow Valley Lakes Drive
Willow Street, PA 17584-9663

Phone

(717) 464-6861

Fax

(717) 464-8444

NPI assigned

Nov 7, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Amy Nicole Nielsen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541548800000",
    "number": "1689142754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 WILLOW VALLEY LAKES DRIVE",
            "city": "WILLOW STREET",
            "state": "PA",
            "postal_code": "175849663",
            "telephone_number": "717-464-6861",
            "fax_number": "717-464-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 WILLOW VALLEY LAKES DRIVE",
            "city": "WILLOW STREET",
            "state": "PA",
            "postal_code": "175849663",
            "telephone_number": "717-464-6861",
            "fax_number": "717-464-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEELEN",
        "first_name": "AMY",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-07",
        "last_updated": "2018-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL005882L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "NIELSEN",
            "middle_name": "NICOLE",
            "prefix": "MISS",
            "credential": "MS CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Speech-Language Pathologist in Willow Street, PA
• Providers in Willow Street, PA by specialty
• Speech-Language Pathologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2018; 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.