Kathryn Lynn Main, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL60306905 Issued in WA

Practice address

4407 N Division St
Ste 303
Spokane, WA 99207-1600

Phone

(509) 710-5084

Fax

(509) 863-9849

NPI assigned

Nov 15, 2012

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

Other identifiers 2

Other names 1

• Kathryn Lynn McDonnell Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Spokane Speech Language Pathology

  • Speech-Language Pathologist
  • Spokane, WA
  • NPI 1831415645
  NPD (past)

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352937600000",
    "number": "1851635924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4407 N DIVISION ST",
            "address_2": "STE 303",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992071600",
            "telephone_number": "509-710-5084",
            "fax_number": "509-863-9849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4407 N DIVISION ST",
            "address_2": "STE 303",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992071600",
            "telephone_number": "509-710-5084",
            "fax_number": "509-863-9849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIN",
        "first_name": "KATHRYN",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL60306905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN SPEECH AND HEARING ASSOCIATION",
            "identifier": "14033267",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "LL60306905",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "MCDONNELL",
            "middle_name": "LYNN",
            "credential": "MA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mickayla Risenmay Mahoney, LMHCA, MS, BA
• Tracy Audrey Mahoney, M.A., MSW
• Heavin Bortz Maier, OD
• Mitchell J.V. Maier, O.D.
• Jediah A Main, MS, NCC, LMHC
• Anthony David Maine Rouwhorst, LMT
• Jill Suzanne Maine, PSYD
• Orson A Maine
• Michael Jacks Mainer, M.D.
• Stacey F Mainer, ARNP

• Speech-Language Pathologist in Spokane, WA
• Providers in Spokane, WA by specialty
• Speech-Language Pathologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; 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.