Individual provider Active NPI

Heidelise Corriveau, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Winooski, VT
National Provider Identifier
1700444890
Registry record updated Jun 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8055194 Issued in VT
Practice address
21A Shepard St
Winooski, VT 05404-1747
Phone
(802) 233-6564
NPI assigned
Jun 3, 2019
Last updated
Jun 3, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 8055194 VT Primary

Addresses

Primary practice location

21A Shepard St
Winooski, VT 05404-1747

Mailing address

21A Shepard St
Winooski, VT 05404-1747
Phone (802) 233-6564

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
8055194VTMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1559520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559520000000",
    "number": "1700444890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21A SHEPARD ST",
            "city": "WINOOSKI",
            "state": "VT",
            "postal_code": "054041747",
            "telephone_number": "802-233-6564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21A SHEPARD ST",
            "city": "WINOOSKI",
            "state": "VT",
            "postal_code": "054041747",
            "telephone_number": "802-233-6564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORRIVEAU",
        "first_name": "HEIDELISE",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-03",
        "last_updated": "2019-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VT",
            "license": "8055194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winooski, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2019; 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.