Stephanie Elizabeth Amundsen, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7101006303 Issued in MI

Practice address

2885 10 Mile Rd NE
Rockford, MI 49341-9177

Phone

(616) 326-0010

Fax

(616) 326-0011

NPI assigned

Jan 16, 2020

Last updated

Jan 16, 2020By the provider in NPPES

Sex

Female

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1579132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1841820040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17872 CHEROKEE DR",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494569404",
            "telephone_number": "616-502-5756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2885 10 MILE RD NE",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493419177",
            "telephone_number": "616-326-0010",
            "fax_number": "616-326-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMUNDSEN",
        "first_name": "STEPHANIE",
        "middle_name": "ELIZABETH",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-16",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101006303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Rockford, MI
• Providers in Rockford, 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 Jan 16, 2020; 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.