Active NPI
Julissa Depe, M.S, CCC-SLP
- Speech-Language Pathologist
- Edmond, OK
National Provider Identifier
1831836642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 5339
- Practice address
- 301 S Boulevard Ste 126
Edmond, OK 73034-3880 - Phone
- (405) 285-6765
- NPI assigned
- May 13, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 | 5339 | OK | Primary |
Addresses
Primary practice location
301 S Boulevard Ste 126
Edmond, OK 73034-3880
Mailing address
2257 Red Bird
Edmond, OK 73012-3162
Other practice location 1
2257 Red Bird
Edmond, OK 73012-3162
Phone (405) 509-0160
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5339 | OK | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655683200000",
"number": "1831836642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2257 RED BIRD",
"city": "EDMOND",
"state": "OK",
"postal_code": "730123162"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 S BOULEVARD STE 126",
"city": "EDMOND",
"state": "OK",
"postal_code": "730343880",
"telephone_number": "405-285-6765"
}
],
"practiceLocations": [
{
"address_1": "2257 Red Bird",
"address_purpose": "LOCATION",
"city": "Edmond",
"state": "OK",
"postal_code": "730123162",
"country_code": "US",
"telephone_number": "405-509-0160",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DEPE",
"first_name": "JULISSA",
"credential": "M.S, CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-05-13",
"last_updated": "2022-06-20",
"certification_date": "2022-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "OK",
"license": "5339",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.