Alicia Anne Cooper, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Verona, WI
NPI 1831696871 · NPPES record last updated Apr 6, 2018
Key facts
- NPI
- 1831696871
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 4613-154 (WI)
- Practice address
- 339 Prairie Oaks Dr
Verona, WI 53593-2005 - Phone
- (217) 552-2896
- NPI assigned
- Apr 6, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Oasis Therapy Services LLC
Practice addresses (Care Compare)
631 Hazel St
Oshkosh, WI 54901-4600
Phone (920) 393-9998
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200710001401 | WI | Practitioner - Qualified Speech Language Pathologist | 3779906656 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oasis Therapy Services LLC | Speech-Language Pathologist | Current |
Accepting new patients |
| Fox Rehabilitation Services Wi LLC | Single Specialty | Current |
Accepting new patients |
Locations
8170 McCormick Blvd
Ste 112
Skokie, IL 60076
Phone (920) 252-4442
7 Carnegie Plz
Cherry Hill, NJ 08003
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist |
235Z00000X | 4613-154 | WI | Yes |
Addresses
Primary practice location
339 Prairie Oaks Dr
Verona, WI 53593-2005
Mailing address
339 Prairie Oaks Dr
Verona, WI 53593-2005
Phone (217) 552-2896
Other names
- Alicia Anne Brach
Other providers in Verona, WI
- Sarah Clemons-Wagner
- Mackinzie Justine Collins
- Communication Innovations, Inc
- Rikki Conwell
- Janice Cooney
- Samantha N Cordum
- Core Integrated Health SC
- Adamaris Corniel Abreu
- Costco Wholesale Corporation
- Costco Wholesale Corporation
All providers in Verona, WI · Speech-Language Pathologist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 6, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.