Active NPI
Amanda Pavalko, MS, CCC/SLP
- Speech-Language Pathologist
- Frackville, PA
National Provider Identifier
1821569310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SL012078
- Practice address
- 1000 W Oak St
Frackville, PA 17931-1643 - Phone
- (888) 929-7677
- Fax
- (888) 929-7677
- NPI assigned
- Dec 10, 2018
- Last updated
- Dec 10, 2018
- 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 | SL012078 | PA | Primary |
Addresses
Primary practice location
1000 W Oak St
Frackville, PA 17931-1643
Mailing address
530 W Spring St
Frackville, PA 17931
Phone (570) 590-8266
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SL012078 | PA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544400000000",
"number": "1821569310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "530 W SPRING ST",
"city": "FRACKVILLE",
"state": "PA",
"postal_code": "17931",
"telephone_number": "570-590-8266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 W OAK ST",
"city": "FRACKVILLE",
"state": "PA",
"postal_code": "179311643",
"telephone_number": "888-929-7677",
"fax_number": "888-929-7677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAVALKO",
"first_name": "AMANDA",
"credential": "MS, CCC/SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-10",
"last_updated": "2018-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "PA",
"license": "SL012078",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Frackville, PA
- Casey D. Nowak, DO
- Brian Michael O'Connell, DPT
- Oak HRC Broad Mountain LLC (Broad Mountain Health and Rehabilitation Center)
- Debra L. Papp, CRNP
- David Dean Paul, DDS
- Phoenix Rehabilitation and Health Services, Inc.
- Sheila Elizabeth Purcell, MSOTRL
- Michael Anthony Rainis Jr., PT
- Marie J Reiley, PTA
- Jennifer C Renninger, PAC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.