Nicole Arlette Beale -Vandyke, CSLP-A, ITDS

Primary specialty

Speech-Language AssistantTaxonomy code 2355S0801X

License

S11425 Issued in FL

Practice address

12485 SW 137TH Ave Ste 301
Miami, FL 33186-4219

Phone

(786) 732-4922

NPI assigned

Aug 26, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Nicole A Vandyke Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1251244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1790918647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12485 SW 137TH AVE STE 301",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331864219",
            "telephone_number": "786-732-4922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12485 SW 137TH AVE STE 301",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331864219",
            "telephone_number": "786-732-4922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEALE -VANDYKE",
        "first_name": "NICOLE",
        "middle_name": "ARLETTE",
        "name_prefix": "Ms.",
        "credential": "CSLP-A, ITDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-26",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "FL",
            "license": "S11425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECH PATHOLOGY ASSISTANT",
            "identifier": "SI1425",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "VANDYKE",
            "middle_name": "A",
            "credential": "CSLPA, ITDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Speech-Language Assistant in Miami, FL
• Providers in Miami, FL by specialty
• Speech-Language Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; 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.