The Speech Pathology Learning Center, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL00002194 Issued in WA

Legal business name

THE SPEECH PATHOLOGY LEARNING CENTER, LLC

Practice address

8514 W Gage Blvd
Kennewick, WA 99336-8120

Phone

(509) 735-6442

Fax

(866) 523-1692

NPI assigned

Oct 2, 2008

Organization subpart

No

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

Authorized official

Name

Denise Ciarlo, CCC/SLP, MA

Title

Owner/Provider

Phone

(509) 735-6442

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222905600000",
    "number": "1720239221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8514 W GAGE BLVD",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993368120",
            "telephone_number": "509-735-6442",
            "fax_number": "866-523-1692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8514 W GAGE BLVD",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993368120",
            "telephone_number": "509-735-6442",
            "fax_number": "866-523-1692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SPEECH PATHOLOGY LEARNING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-02",
        "last_updated": "2008-10-02",
        "status": "A",
        "authorized_official_last_name": "CIARLO",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "509-735-6442",
        "authorized_official_credential": "CCC/SLP, MA"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "WA",
            "license": "OT00001974",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL00002194",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL00004503",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7136526",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2008; 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.