NPIMap

Organization Active NPI

Speech Language Associates LLC

  • Speech-Language Pathologist
  • Mount Laurel, NJ
National Provider Identifier
1760916969
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
SPEECH LANGUAGE ASSOCIATES LLC
Practice address
204 Ark Rd # 103C
Mount Laurel, NJ 08054-3100
Phone
(856) 492-1355
NPI assigned
Apr 13, 2017
Last updated
Jan 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Authorized official

Name
Donna Clark
Title
Practice Manager
Phone
(856) 492-1355

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
AudiologistGroup: 193200000X MULTI-SPECIALTY GROUP 231H00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X Primary
Audiologist-Hearing Aid FitterGroup: 193200000X MULTI-SPECIALTY GROUP 237600000X

Addresses

Primary practice location

204 Ark Rd # 103C
Mount Laurel, NJ 08054-3100

Mailing address

704 Heritage Rd
Cinnaminson, NJ 08077-3702
Phone (856) 492-1355

Other practice location 1

1124 Patriot Way
Eastampton, NJ 08060-9624
Phone (856) 492-1355

Other practice location 2

80 Stecher Ave
Delran, NJ 08075-1463
Phone (609) 492-1355

Other names 1

  • Elevate Health & Therapeutic Services Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211208002375 NJ Part B Supplier - Clinic/Group Practice 3173913068 Receives reassigned benefits from 9 practitioners
Practice locations: Cinnaminson, NJ

National Provider Directory

National Provider Directory

Locations

1124 Patriot Way
Mount Holly, NJ 08060
Phone (856) 432-1355

1015 Briggs Rd
Mount Laurel, NJ 08054
Phone (856) 727-0900

1015 Briggs Rd
Ste 150
Mount Laurel, NJ 08054
Phone (856) 492-1355

204 Ark Rd
#103
Mount Laurel, NJ 08054
Phone (856) 492-1355

204 Ark Rd
#103C
Mount Laurel, NJ 08054
Phone (856) 492-1355

204 Ark Rd
Ste 103C
Mount Laurel, NJ 08054
Phone (856) 492-1355

204 Ark Rd
Ste 105C
Mount Laurel, NJ 08054
Phone (856) 492-1355

Practitioners & affiliated clinicians

Practitioners 43

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.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1492041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705449600000",
    "number": "1760916969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 HERITAGE RD",
            "city": "CINNAMINSON",
            "state": "NJ",
            "postal_code": "080773702",
            "telephone_number": "856-492-1355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 ARK RD # 103C",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080543100",
            "telephone_number": "856-492-1355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1124 Patriot Way",
            "address_purpose": "LOCATION",
            "city": "Eastampton",
            "state": "NJ",
            "postal_code": "080609624",
            "country_code": "US",
            "telephone_number": "856-492-1355",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "80 Stecher Ave",
            "address_purpose": "LOCATION",
            "city": "Delran",
            "state": "NJ",
            "postal_code": "080751463",
            "country_code": "US",
            "telephone_number": "609-492-1355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPEECH LANGUAGE ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-13",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "856-492-1355"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elevate Health & Therapeutic Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mount Laurel, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; 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.