Individual provider Active NPI

Cynthia Michalak, MS, CCC/SLP

  • Speech-Language Pathologist
  • Mequon, WI
National Provider Identifier
1740379189
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
806-154 Issued in WI
Practice address
10602 N Port Washington Rd
Suite 101
Mequon, WI 53092-5079
Phone
(262) 241-8030
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 806-154 WI Primary

Addresses

Primary practice location

10602 N Port Washington Rd
Suite 101
Mequon, WI 53092-5079

Mailing address

3320 S 76TH St
Milwaukee, WI 53219-3805

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
806-154WIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740379189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 S 76TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532193805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10602 N PORT WASHINGTON RD",
            "address_2": "SUITE 101",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925079",
            "telephone_number": "262-241-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHALAK",
        "first_name": "CYNTHIA",
        "credential": "MS, CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "806-154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.