Beverly Gough, MA CCC SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

6744-SL Issued in MA

Practice address

1635 W Big Beaver Rd
Troy, MI 48084-3501

Phone

(248) 816-7000

Fax

(248) 928-0523

NPI assigned

Nov 15, 2012

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

Practice roles

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.

• Language Learning Technologies, LTD

  • Speech-Language Pathologist
  • Troy, MI
  • NPI 1285623496
  NPD (past) Authorized official

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352937600000",
    "number": "1790029866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 W BIG BEAVER RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843501",
            "telephone_number": "248-816-7000",
            "fax_number": "248-928-0523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 W BIG BEAVER RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843501",
            "telephone_number": "248-816-7000",
            "fax_number": "248-928-0523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUGH",
        "first_name": "BEVERLY",
        "credential": "MA CCC SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "6744-SL",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith Jerome Gorny, PA
• Rebecca Gorz, DO
• Jeana Goss, PT, DPT
• Louise Gott
• Jordan Gougeon
• Amanda Morgan Goulet
• Ann Gourlay
• Michael Govan
• Reshma M Gowda, DDS
• Jenna Marie Gower

• Speech-Language Pathologist in Troy, MI
• Providers in Troy, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; 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.