Olivia Mickola, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

015940 Issued in OR

Practice address

2305 SE Washington St Ste 102
Milwaukie, OR 97222-7647

Phone

(503) 654-1014

Fax

(503) 654-1148

NPI assigned

Dec 6, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Clackamas Speech LLC

  • Hearing and Speech Clinic/Center
  • Milwaukie, OR
  • NPI 1831581131
  NPD (past)

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

{
    "created_epoch": "1544054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544054400000",
    "number": "1710458484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2305 SE WASHINGTON ST STE 102",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972227647",
            "telephone_number": "503-654-1014",
            "fax_number": "503-654-1148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 SE WASHINGTON ST STE 102",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972227647",
            "telephone_number": "503-654-1014",
            "fax_number": "503-654-1148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKOLA",
        "first_name": "OLIVIA",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-06",
        "last_updated": "2018-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "015940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSPA",
            "identifier": "015940",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jerry Michaels, PHYSICAL THERAPIST
• Rhoberta E Michaels, LPC, NCC, LCPC
• Brittney Jane Michaud, LMT
• Michelle Denise Roberts
• Joel Aaron Michels, F.N.P
• Anja Middelzick, L.AC., LMT
• Jenna Mieras
• Milestones Therapeutics, LLC
• Kristin Milio, CCC-SLP
• Charles A. Miller III, DMD

• Speech-Language Pathologist in Milwaukie, OR
• Providers in Milwaukie, OR by specialty
• Speech-Language Pathologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2018; 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.