Renew Speech Language Pathology

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

03592 Issued in MD

Legal business name

RENEW SPEECH LANGUAGE PATHOLOGY

Practice address

8644 Water Fall Dr
Laurel, MD 20723-2033

Phone

(240) 472-8987

NPI assigned

Jun 12, 2017

Last updated

Jun 15, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dorinda MalcolmNPI 1073045894

Title

Speech Language Pathologist

Phone

(240) 472-8987

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

Enrollment records 2

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dorinda Malcolm, M.A.,CCC-SLP

  • Speech-Language Pathologist
  • Laurel, MD
  • NPI 1073045894

  DC

  Medicare reassignment Care Compare group NPD Authorized official
• Brooke Bergman

  • Speech-Language Pathologist
  • Gaithersburg, MD
  • NPI 1528466349
  Medicare reassignment Care Compare group NPD
• Max Elliot Kaplan

  • Speech-Language Pathologist
  • Columbia, MD
  • NPI 1467294264
  Medicare reassignment Care Compare group NPD
• Merena Sarnecki, M.A.

  • Speech-Language Pathologist
  • Ellicott City, MD
  • NPI 1366855439
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1497225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560556800000",
    "number": "1730619875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8644 WATER FALL DR",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207232033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8644 WATER FALL DR",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207232033",
            "telephone_number": "240-472-8987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW SPEECH LANGUAGE PATHOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-12",
        "last_updated": "2019-06-15",
        "status": "A",
        "authorized_official_last_name": "MALCOLM",
        "authorized_official_first_name": "DORINDA",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "240-472-8987"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "03592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Laurel, MD
• Providers in Laurel, MD by specialty
• Speech-Language Pathologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.