Shannon Colleen Wisocky, MA

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SL006206L Issued in PA

Practice address

4213 Cider Press Rd
Slatington, PA 18080-3158

Phone

(610) 217-7482

NPI assigned

Apr 19, 2017

Last updated

Apr 19, 2017By the provider in NPPES

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": "1492560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492560000000",
    "number": "1780118521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4213 CIDER PRESS RD",
            "city": "SLATINGTON",
            "state": "PA",
            "postal_code": "180803158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4213 CIDER PRESS RD",
            "city": "SLATINGTON",
            "state": "PA",
            "postal_code": "180803158",
            "telephone_number": "610-217-7482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISOCKY",
        "first_name": "SHANNON",
        "middle_name": "COLLEEN",
        "name_prefix": "Mrs.",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-19",
        "last_updated": "2017-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL006206L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott T Vanduzer, M.D.
• Stephanie Kristine Vanduzer, M.D.
• Shannon R Vaught, MA, CAADC
• Elexus Wilson
• Mary Wiseman, PT, DPT, GCS
• Hannah M Wittman, MA, ATR-BC, LPC
• Gallus Wukitsch
• Kyle Zehner

• Speech-Language Pathologist in Slatington, PA
• Providers in Slatington, PA by specialty
• Speech-Language Pathologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2017; 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.