Mikayla Marie Bellardini, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

117146 Issued in TX

Practice address

512 Peach St
Crowley, TX 76036-3119

Phone

(817) 297-5880

NPI assigned

Aug 22, 2019

Last updated

Sep 12, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Electronic endpoints 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

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

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1720635915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2132 BARBELL LN",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761115017",
            "telephone_number": "727-348-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 PEACH ST",
            "city": "CROWLEY",
            "state": "TX",
            "postal_code": "760363119",
            "telephone_number": "817-297-5880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60160 Venable Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Hood",
            "state": "TX",
            "postal_code": "765443610",
            "country_code": "US",
            "telephone_number": "254-336-1980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BELLARDINI",
        "first_name": "MIKAYLA",
        "middle_name": "MARIE",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-22",
        "last_updated": "2022-09-12",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "6654",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "117146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS LLR",
            "identifier": "117146",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC LLR",
            "identifier": "6654",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHA",
            "identifier": "14258638",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mikayla.bellardini@crowley.k12.tx.us",
            "affiliation": "N",
            "endpointDescription": "School Based Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "512 Peach St",
            "city": "Crowley",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760363119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Speech-Language Pathologist in Crowley, TX
• Providers in Crowley, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; 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.