Jennifer Dianne Wadsworth Guzman, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

104644 Issued in TX

Practice address

170 Meeting St Ste 110
Charleston, SC 29401-3178

Phone

(512) 399-0064

NPI assigned

Aug 31, 2011

Last updated

Oct 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jennifer Dianne Wadsworth Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Lanakila Early Childhood Services Program

  • Early Intervention Provider Agency
  • Honolulu, HI
  • NPI 1710258405
  NPD (past)

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

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1770864977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 LANAKILA AVE RM 210",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968172115",
            "telephone_number": "808-832-5688",
            "fax_number": "808-832-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 MEETING ST STE 110",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294013178",
            "telephone_number": "512-399-0064"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 Lanakila Ave Rm 210",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968172115",
            "country_code": "US",
            "telephone_number": "808-832-5688",
            "fax_number": "808-832-5698",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3800 N LaMar Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787560003",
            "country_code": "US",
            "telephone_number": "512-399-0064",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "633 W 5th St Ofc 2876B",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900712005",
            "country_code": "US",
            "telephone_number": "512-399-0064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUZMAN",
        "first_name": "JENNIFER",
        "middle_name": "DIANNE WADSWORTH",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-31",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "HI",
            "license": "1162",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "104644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "WADSWORTH",
            "middle_name": "DIANNE",
            "credential": "CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ashwath Gurumurthi, MBBS
• Kristina K Gustafson, MD
• Ethan Christopher Guthrie, RBT
• Michael Guthrie, PHARM.D.
• Lydia Guy
• Melissa Angelina Guzzi, BSN, RN
• Gwendolyn B. Brown,D.M.D.,L.L.C. (Brown & Associates Family Dentistry)
• Bruce H Gwinnup, DC
• Caillyn Robert Gwinnup, DC
• Mackenzie Gwynne, M.D.

• Speech-Language Pathologist in Charleston, SC
• Providers in Charleston, SC by specialty
• Speech-Language Pathologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2022; 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.