Virginia Pellissier, M.A. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

22004175A Issued in IN

Practice address

6437 Rucker Rd Ste D
Indianapolis, IN 46220-4868

Phone

(317) 405-9016

Fax

(888) 654-4116

NPI assigned

Apr 14, 2025

Sex

Female

Sole proprietor

No

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pediatric Specialty Associates, Inc

  • Early Intervention Provider Agency
  • Indianapolis, IN
  • NPI 1336212638

  Speech-Language Pathologist

  NPD
• Pediatric Specialty Associates, Inc

  • Early Intervention Provider Agency
  • Indianapolis, IN
  • NPI 1346628492
  NPD (past)

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

{
    "created_epoch": "1744588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1750176335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13026 FAWNSBROOK DR",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460381036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6437 RUCKER RD STE D",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462204868",
            "telephone_number": "317-405-9016",
            "fax_number": "888-654-4116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLISSIER",
        "first_name": "VIRGINIA",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-14",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22004175A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emil Pelech Jr., MD
• Carly Pelfrey
• Craig James Pelka, MSW
• Leslie Michell Pell, NP.RN.CNP, APRN,PMHN
• Scott Pelley, LSW
• Terri A Pellow, MD
• Daniel Christopher Peltier, M.D.
• Ashley Pelton
• Brenda Marlene Pelz, PTA
• Cierra Pena

• Speech-Language Pathologist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Speech-Language Pathologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; 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.