Kelly Declark

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7152001440 Issued in MI

Practice address

10483 Dixie Hwy
Holly, MI 48442-9311

Phone

(810) 771-7686

NPI assigned

Jun 9, 2026

Last updated

Jun 9, 2026By the provider in NPPES

Sex

Unspecified or another gender identity

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Qualified Speech Language Pathologist

Education

Other, 2026

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Level 11 Physical TherapyGroup PAC ID 8527104835, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Level 11 Physical Therapy

  dba Level 11

  • Rehabilitation Clinic/Center
  • Holly, MI
  • NPI 1730317785
  Care Compare group
• Level Eleven Howell

  • Rehabilitation Clinic/Center
  • Howell, MI
  • NPI 1174998801
  NPD
• Level Eleven Howell, LLC

  • Clinic/Center
  • Howell, MI
  • NPI 1376321174
  NPD
• Level Eleven Saginaw

  • Physical Therapy Clinic/Center
  • Saginaw, MI
  • NPI 1720320583
  NPD
• Level Eleven Saginaw, LLC

  • Rehabilitation Clinic/Center
  • Saginaw, MI
  • NPI 1164201679
  NPD

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

{
    "created_epoch": "1780963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1841124740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10483 DIXIE HWY",
            "city": "HOLLY",
            "state": "MI",
            "postal_code": "484429311",
            "telephone_number": "810-771-7686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10483 DIXIE HWY",
            "city": "HOLLY",
            "state": "MI",
            "postal_code": "484429311",
            "telephone_number": "810-771-7686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECLARK",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2026-06-09",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7152001440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Ligerakis Coop, DDS
• Darlene a Stieber PHD PC
• Dawn Ag Kulongowski, DDS, PC (Creative Smiles Dental Group)
• Dawson Counseling LLC
• Brian Wade Dawson, L.M.S.W.
• Devary Chiropractic Wellness Center (Well Adjusted Chiropractic)
• Shawn Allan Devary, DC
• Dixie Lodge, LLC (Rehab Without Walls NeuroSolutions)
• Thomas David Dodge
• Downtown Wellness PLLC

• Speech-Language Pathologist in Holly, MI
• Providers in Holly, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.