Active NPI
Stacey Umunna, CCC-SLP
- Speech-Language Pathologist
- Gaithersburg, MD
National Provider Identifier
1700610250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 11258
- Practice address
- 101 Education Blvd
Gaithersburg, MD 20877-2398 - Phone
- (301) 284-4500
- NPI assigned
- Aug 28, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 11258 | MD | Primary |
Addresses
Primary practice location
101 Education Blvd
Gaithersburg, MD 20877-2398
Mailing address
PO Box 1312
Washington Grove, MD 20880-1312
Phone (301) 841-7879
Other practice location 1
7 Daylily Ln
Washington Grove, MD 20880-2036
Phone (301) 841-7879
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11258 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724803200000",
"number": "1700610250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1312",
"city": "WASHINGTON GROVE",
"state": "MD",
"postal_code": "208801312",
"telephone_number": "301-841-7879"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 EDUCATION BLVD",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208772398",
"telephone_number": "301-284-4500"
}
],
"practiceLocations": [
{
"address_1": "7 Daylily Ln",
"address_purpose": "LOCATION",
"city": "Washington Grove",
"state": "MD",
"postal_code": "208802036",
"country_code": "US",
"telephone_number": "301-841-7879",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "UMUNNA",
"first_name": "STACEY",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-08-28",
"last_updated": "2024-08-28",
"certification_date": "2024-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MD",
"license": "11258",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gaithersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.