Sundance Speech Therapy, PLLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

SUNDANCE SPEECH THERAPY, PLLC

Practice address

829 Sylvan Dr
Fort Worth, TX 76120-2851

Phone

(817) 526-2731

NPI assigned

Mar 26, 2022

Last updated

Mar 26, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Katie Young, M.S., CCC-SLPNPI 1972058816

Title

Speech-Language Pathologist

Phone

(817) 526-2731

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Katie Young, M.S.,CCC-SLP

  • Speech-Language Pathologist
  • Fort Worth, TX
  • NPI 1972058816
  NPD Authorized official

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

{
    "created_epoch": "1648252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648252800000",
    "number": "1811647472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "829 SYLVAN DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761202851",
            "telephone_number": "817-526-2731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "829 SYLVAN DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761202851",
            "telephone_number": "817-526-2731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNDANCE SPEECH THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-26",
        "last_updated": "2022-03-26",
        "certification_date": "2022-03-26",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "817-526-2731",
        "authorized_official_credential": "M.S., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2022; 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.