Active NPI
Speak Your Mind Speech and Language PLLC
- Speech-Language Pathologist
- Wheaton, IL
National Provider Identifier
1700417748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Legal business name
- SPEAK YOUR MIND SPEECH AND LANGUAGE PLLC
- Practice address
- 402 E Roosevelt Rd Ste 104
Wheaton, IL 60187-5588 - Phone
- (630) 765-5890
- NPI assigned
- Jan 29, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lorissa Bertolini Grant, CCC-SLP
- Title
- Speech Language Pathologist
- Phone
- (201) 602-3374
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | Primary |
Addresses
Primary practice location
402 E Roosevelt Rd Ste 104
Wheaton, IL 60187-5588
Mailing address
1326 Campbell Ave
Wheaton, IL 60189-6510
Phone (201) 602-3374
National Provider Directory
National Provider DirectoryLocations
402 E Roosevelt Rd
Ste 104
Wheaton, IL 60187
Phone (630) 765-5890
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Speech-Language Pathologist
- Friendswood, TX
- NPI 1366807547
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580256000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1580256000000",
"number": "1700417748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1326 CAMPBELL AVE",
"city": "WHEATON",
"state": "IL",
"postal_code": "601896510",
"telephone_number": "201-602-3374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "402 E ROOSEVELT RD STE 104",
"city": "WHEATON",
"state": "IL",
"postal_code": "601875588",
"telephone_number": "630-765-5890"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SPEAK YOUR MIND SPEECH AND LANGUAGE PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-01-29",
"last_updated": "2020-01-29",
"certification_date": "2020-01-29",
"status": "A",
"authorized_official_last_name": "GRANT",
"authorized_official_first_name": "LORISSA",
"authorized_official_middle_name": "BERTOLINI",
"authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
"authorized_official_telephone_number": "201-602-3374",
"authorized_official_credential": "CCC-SLP"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wheaton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.