Active NPI
Marissa Lynn Humphrey, CCC-SLP
- Speech-Language Pathologist
- Davison, MI
National Provider Identifier
1801405022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 7101006194
- Practice address
- 9100 Lapeer Rd Ste C
Davison, MI 48423-3620 - Phone
- (810) 412-4183
- Fax
- (810) 309-8635
- NPI assigned
- Jul 23, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 7101006194 | MI | Primary |
Addresses
Primary practice location
9100 Lapeer Rd Ste C
Davison, MI 48423-3620
Mailing address
9100 Lapeer Rd Ste C
Davison, MI 48423-3620
Phone (810) 412-4183
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Speech Language Pathologist
- Education
- Central Michigan College of Medicine, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3196 S Irish Rd
Davison, MI 48423-2434
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7101006194 | MI | MD | Speech-Language Pathologist |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762905600000",
"number": "1801405022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9100 LAPEER RD STE C",
"city": "DAVISON",
"state": "MI",
"postal_code": "484233620",
"telephone_number": "810-412-4183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9100 LAPEER RD STE C",
"city": "DAVISON",
"state": "MI",
"postal_code": "484233620",
"telephone_number": "810-412-4183",
"fax_number": "810-309-8635"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUMPHREY",
"first_name": "MARISSA",
"middle_name": "LYNN",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-23",
"last_updated": "2025-11-12",
"certification_date": "2025-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MI",
"license": "7101006194",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Davison, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.