Katherine Jayne Kettler Smith, M.A. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

6547402-4102 Issued in UT

Practice address

670 E 3900 S
Millcreek, UT 84107-1973

Phone

(801) 266-3979

NPI assigned

Sep 7, 2023

Last updated

Sep 7, 2023By 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

Other names 1

• Katherine Jayne Kettler Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1694044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1861278400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 E 3900 S",
            "city": "MILLCREEK",
            "state": "UT",
            "postal_code": "841071973",
            "telephone_number": "801-266-3979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 E 3900 S",
            "city": "MILLCREEK",
            "state": "UT",
            "postal_code": "841071973",
            "telephone_number": "801-266-3979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KATHERINE",
        "middle_name": "JAYNE KETTLER",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-07",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "UT",
            "license": "6547402-4102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "KETTLER",
            "middle_name": "JAYNE",
            "credential": "M.A. CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shewolfe, LLC (NiShe Counseling)
• Sydney Salome Shultz, LCSW
• Kadence Smith, RBT
• Karl Scott Smith III
• Katherine Bradshaw Smith, NP
• Lesa A Smith, MSW, CSW
• Solstice Trauma Healing LLC
• Soul Logic Counseling
• Soul Pathways Wellness, LLC
• Jorri Lee Sparks, MSN, APRN, FNP-BC

• Speech-Language Pathologist in Millcreek, UT
• Providers in Millcreek, UT by specialty
• Speech-Language Pathologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.