Individual provider Active NPI

Stefanie Jeane Alliss, SLPA

  • Speech-Language Assistant
  • Lake Havasu City, AZ
National Provider Identifier
1740771674
Registry record updated May 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
SLPA10438 Issued in AZ
Practice address
3180 Arapaho Dr Apt 101
Lake Havasu City, AZ 86406-5778
Phone
(928) 566-5475
NPI assigned
May 26, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X SLPA10438 AZ Primary

Addresses

Primary practice location

3180 Arapaho Dr Apt 101
Lake Havasu City, AZ 86406-5778

Mailing address

3180 Arapaho Dr Apt 101
Lake Havasu City, AZ 86406-5778
Phone (928) 566-5475

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

State licenses

LicenseStateTypeSpecialty
SLPA10438AZMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1527292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527292800000",
    "number": "1740771674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3180 ARAPAHO DR APT 101",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864065778",
            "telephone_number": "928-566-5475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 ARAPAHO DR APT 101",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864065778",
            "telephone_number": "928-566-5475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLISS",
        "first_name": "STEFANIE",
        "middle_name": "JEANE",
        "name_prefix": "Ms.",
        "credential": "SLPA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-26",
        "last_updated": "2018-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "AZ",
            "license": "SLPA10438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2018; 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.