Origin Autism Diagnostic Clinic Inc

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

ORIGIN AUTISM DIAGNOSTIC CLINIC INC

Practice address

6349 Piccadilly Square Dr Ste B
Mobile, AL 36609-5103

Phone

(251) 554-4525

NPI assigned

Aug 13, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Leighton B Dees II

Title

Owner

Phone

(251) 554-4525

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1723507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1700617545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8760 WINFORD WAY",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366194318",
            "telephone_number": "251-554-4525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6349 PICCADILLY SQUARE DR STE B",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366095103",
            "telephone_number": "251-554-4525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORIGIN AUTISM DIAGNOSTIC CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-13",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "DEES",
        "authorized_official_first_name": "LEIGHTON",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "251-554-4525",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Mobile, AL
• Providers in Mobile, AL by specialty
• Speech-Language Pathologist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.

Verify at the official NPI Registry.