Mandilyn Marie Cole, MS CCC SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

22003885A Issued in IN

Practice address

4850 Whippoorwill Dr
Lafayette, IN 47909

Phone

(765) 714-5004

Fax

(765) 538-2205

NPI assigned

Oct 24, 2006

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 identifiers 1

Other names 1

• Miss Mandillyn Marie Myers 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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700969359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 WHIPPOORWILL DR",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "47909",
            "telephone_number": "765-538-2205",
            "fax_number": "765-538-2205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 WHIPPOORWILL DR",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "47909",
            "telephone_number": "765-714-5004",
            "fax_number": "765-538-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE",
        "first_name": "MANDILYN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MS CCC SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22003885A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2004138",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANDILLYN",
            "last_name": "MYERS",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ethan Cohen
• Marisa Cohen, PA-C
• Lauren Colbert, MS CCC-SLP
• Cole Vision Corporation
• Erica Cole
• Raeven N Cole, CNM
• Shellene Coleman, APN
• Collaborative Care, LLC
• Christy L Collette, M.A., LMHC
• Jayda Collins-Ruiz

• Speech-Language Pathologist in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Speech-Language Pathologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.