Kelly Radford Licquia, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA13231 Issued in FL

Practice address

3711 Shamrock W Apt N264
Tallahassee, FL 32309-2699

Phone

(850) 566-2944

NPI assigned

Dec 22, 2006

Last updated

Nov 2, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1811052525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3711 SHAMROCK W APT N264",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323092699",
            "telephone_number": "850-566-2944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3711 SHAMROCK W APT N264",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323092699",
            "telephone_number": "850-566-2944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICQUIA",
        "first_name": "KELLY",
        "middle_name": "RADFORD",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-22",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA13231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013610500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7412328",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012952300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hongqin Li, M.D
• Melissa Yuanfang Li
• Jeff Liang, PH.D.
• David Liburd, PT
• David Lemington Liburd Sr., LCSW
• Megan Lieblong
• Shannon Kathleen Liem, MS, CCC-SLP
• Life Inspired Therapy, LLC
• Life Solutions Outpatient Corp
• Life Solutions Outpatient Corp

• Speech-Language Pathologist in Tallahassee, FL
• Providers in Tallahassee, 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 Nov 2, 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.