NPIMap

Organization Active NPI

Iceberg Therapy Services LLC

  • Speech-Language Pathologist
  • Baton Rouge, LA
National Provider Identifier
1831764919
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
ICEBERG THERAPY SERVICES LLC
Practice address
172 Lee Dr Ste 485
Baton Rouge, LA 70808-5088
Phone
(225) 277-3442
NPI assigned
May 21, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2021

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

Authorized official

Name
Jennifer Corie, PHD, CCC-SLPNPI 1033596713
Title
Owner/Speech Langauge Pathologist
Phone
(225) 277-3442

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

172 Lee Dr Ste 485
Baton Rouge, LA 70808-5088

Mailing address

7350 Jefferson Hwy
Suite 485 #231
Baton Rouge, LA 70806
Phone (225) 277-3442

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://icebergts.mytheranest.com/

National Provider Directory

National Provider Directory

Locations

7350 Jefferson Hwy
Ste 485
Baton Rouge, LA 70806

172 Lee Dr
Ste 485
Baton Rouge, LA 70808
Phone (225) 277-3442

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621555200000",
    "number": "1831764919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7350 JEFFERSON HWY",
            "address_2": "SUITE 485 #231",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "70806",
            "telephone_number": "225-277-3442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 LEE DR STE 485",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708085088",
            "telephone_number": "225-277-3442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICEBERG THERAPY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-21",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-06",
        "status": "A",
        "authorized_official_last_name": "CORIE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER/SPEECH LANGAUGE PATHOLOGIST",
        "authorized_official_telephone_number": "225-277-3442",
        "authorized_official_credential": "PHD, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://icebergts.mytheranest.com/",
            "affiliation": "N",
            "endpointDescription": "EHR system",
            "address_1": "7350 Jefferson Hwy",
            "address_2": "Suite 485 #231",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "70806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; 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.