Thrive Online Speech Therapy, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

THRIVE ONLINE SPEECH THERAPY, LLC

Practice address

12305 NE 102ND St
Vancouver, WA 98682-1990

Phone

(503) 475-2763

NPI assigned

Mar 31, 2020

Organization subpart

No

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

Authorized official

Name

Mongoli Yang MouaNPI 1376074138

Title

Owner

Phone

(360) 797-5313

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mongoli Yang Moua, M.S.

  • Speech-Language Pathologist
  • Vancouver, WA
  • NPI 1376074138
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585612800000",
    "number": "1811525140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12305 NE 102ND ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986821990",
            "telephone_number": "503-475-2763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12305 NE 102ND ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986821990",
            "telephone_number": "503-475-2763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THRIVE ONLINE SPEECH THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-31",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A",
        "authorized_official_last_name": "MOUA",
        "authorized_official_first_name": "MONGOLI",
        "authorized_official_middle_name": "YANG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-797-5313"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Speech-Language Pathologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.