Jaclyn Dea Hartley, M.S.,CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

12668 Issued in FL

Practice address

2471 King Arthurs CT
Fort Myers, FL 33912-1640

Phone

(304) 288-6115

NPI assigned

Jul 27, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Gulf Coast Therapy Services LLC

  • Speech-Language Pathologist
  • Fort Myers, FL
  • NPI 1275266355
  NPD Authorized official

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

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1801086772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2471 KING ARTHURS CT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339121640",
            "telephone_number": "304-288-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2471 KING ARTHURS CT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339121640",
            "telephone_number": "304-288-6115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTLEY",
        "first_name": "JACLYN",
        "middle_name": "DEA",
        "credential": "M.S.,CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-27",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WV",
            "license": "SLP-1100",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "12668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Hart, APRN
• Brenda Catineau Hart, O.D.
• Deborah Miriam Hart
• Lowell L. Hart, M.D.
• Stefanie Elizabeth Hart, D.C.
• Callie Hartline
• Gregory Ralph Hartman, D.C.
• Judith A Hartner, M.D.
• Carlysle John Hartsell, B.S.
• Jenna Marie Hartt, PA

• Speech-Language Pathologist in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.