Molly Lynn Shade, M.A. C.F. S.L.P.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

46001693A Issued in IN

Practice address

729 W. 35TH St.
Marion, IN 46953

Phone

(765) 674-3371

NPI assigned

Apr 24, 2007

Sex

Female

Sole proprietor

No

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

Locations

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.

• Children'S Therapy Connection, Inc.

  • Physical Therapist
  • Indianapolis, IN
  • NPI 1366609166
  NPD

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1801015235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7209 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502021",
            "telephone_number": "317-288-7606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 W. 35TH ST.",
            "city": "MARION",
            "state": "IN",
            "postal_code": "46953",
            "telephone_number": "765-674-3371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADE",
        "first_name": "MOLLY",
        "middle_name": "LYNN",
        "credential": "M.A. C.F. S.L.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "46001693A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel D Seitz, MA, LCSW, LMFT, LCAC
• Senior Support Services Inc
• Serenity Pediatric Therapies
• Debra Severson, OTR
• Steven Neil Severson, RPH
• Justin Shaffer, PT
• Kyle P Shaffer, DPT
• Michael Wayne Shaffer, LCSW
• Dhiraj Shah, MD
• Cortney R Shanks, LCSW

• All providers in Marion, IN
• Speech-Language Pathologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.