Individual provider Active NPI

Monica Maki, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Missoula, MT
National Provider Identifier
1720433113
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
9852 Issued in MA
Practice address
2126 Dixon Ave
Missoula, MT 59801-8216
Phone
(406) 541-2776
Fax
(406) 924-7292
NPI assigned
May 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 9852 MA Primary

Addresses

Primary practice location

2126 Dixon Ave
Missoula, MT 59801-8216

Mailing address

2126 Dixon Ave
Missoula, MT 59801-8216

Other practice location 1

40 Mechanic St
Suite 301
Foxboro, MA 02035-2074
Phone (508) 698-3709

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
9852MAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Speech and Voice Therapy Center, LLC Speech-Language Pathologist Past Accepting new patients
Speech and Voice Therapy Center, LLC Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1720433113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2126 DIXON AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598018216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2126 DIXON AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598018216",
            "telephone_number": "406-541-2776",
            "fax_number": "406-924-7292"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 Mechanic St",
            "address_2": "Suite 301",
            "address_purpose": "LOCATION",
            "city": "Foxboro",
            "state": "MA",
            "postal_code": "020352074",
            "country_code": "US",
            "telephone_number": "508-698-3709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAKI",
        "first_name": "MONICA",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-04",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "9852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; 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.