Kaitlyn Vandermaiden, M.A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.015811 Issued in IL

Practice address

2416 S Lowell Ave
Springfield, IL 62704-4641

Phone

(217) 242-5551

NPI assigned

Mar 30, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1680134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1740985886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2416 S LOWELL AVE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044641",
            "telephone_number": "217-242-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2416 S LOWELL AVE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044641",
            "telephone_number": "217-242-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERMAIDEN",
        "first_name": "KAITLYN",
        "name_prefix": "Ms.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-30",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.015811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maryann Oyinkeprebi Van Ryn
• Stephanie Ann Van Ulft, M. D.
• Brenda Vance, LPC
• Melinda M. Vance, FNP-BC
• Gary Vandekerckhove, D.D.S
• Matt Gordon Vandermolen, DDS
• Suzanne Michelle Lynn Vanderslik
• Vicki L Vandeveer, MA, LCPC, LMFT, CADC
• Timothy A Vanfleet, MD
• Scott Anibal Vangemert, MD

• Speech-Language Pathologist in Springfield, IL
• Providers in Springfield, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; 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.