Active NPI
Leslie Anne Tatum, MSCCCSLP
- Speech-Language Pathologist
- Dallas, TX
National Provider Identifier
1841302015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 15284
- Practice address
- 8550 Cadenza LN
Dallas, TX 75228-4923 - Phone
- (214) 328-4309
- Fax
- (214) 328-4309
- NPI assigned
- Aug 31, 2006
- 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 | 15284 | TX | Primary |
Addresses
Primary practice location
8550 Cadenza LN
Dallas, TX 75228-4923
Mailing address
2403 Rebecca Dr
Sachse, TX 75048-4049
Phone (214) 629-8685
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8T0275 | Other | TX | BLUE CROSS BLUE SHIELD |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15284 | TX | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dallas Center, Inc. | Speech-Language Pathologist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Developmental Disabilities Clinic/Center
- Dallas, TX
- NPI 1245304211
Speech-Language Pathologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1841302015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2403 REBECCA DR",
"city": "SACHSE",
"state": "TX",
"postal_code": "750484049",
"telephone_number": "214-629-8685",
"fax_number": "972-530-3702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8550 CADENZA LN",
"city": "DALLAS",
"state": "TX",
"postal_code": "752284923",
"telephone_number": "214-328-4309",
"fax_number": "214-328-4309"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TATUM",
"first_name": "LESLIE",
"middle_name": "ANNE",
"credential": "MSCCCSLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "15284",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "8T0275",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.