Bloomington Pediatric Speech Therapy LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

BLOOMINGTON PEDIATRIC SPEECH THERAPY LLC

Practice address

3002 Ge Rd Ste 2
Bloomington, IL 61704-2502

Phone

(309) 530-6982

NPI assigned

Apr 15, 2025

Last updated

Apr 15, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Leslie Garthaus, CCC-SLPNPI 1124211552

Title

Speech-Language Pathologist

Phone

(309) 530-6982

Specialties & licenses 2

Addresses

Practitioners 1

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.

• Leslie Ann Garthaus, M.S.,CCC-SLP-L

  • Speech-Language Pathologist
  • Bloomington, IL
  • NPI 1124211552
  NPD Authorized official

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

{
    "created_epoch": "1744675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744675200000",
    "number": "1790571107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 WATERSIDE CIR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617042921",
            "telephone_number": "309-530-6982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3002 GE RD STE 2",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617042502",
            "telephone_number": "309-530-6982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMINGTON PEDIATRIC SPEECH THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-15",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A",
        "authorized_official_last_name": "GARTHAUS",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "309-530-6982",
        "authorized_official_credential": "CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Speech-Language Pathologist in Illinois

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