Individual provider Active NPI

Susan Louise Dabo, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Columbus, OH
National Provider Identifier
1861648263
Registry record updated Apr 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP 8302 Issued in OH
Practice address
510 E. North Broadway
Columbus, OH 43214-4114
Phone
(614) 263-5151
Fax
(614) 263-5365
NPI assigned
Aug 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP 8302 OH Primary

Addresses

Primary practice location

510 E. North Broadway
Columbus, OH 43214-4114

Mailing address

510 E. North Broadway
Columbus, OH 43214-4114
Phone (614) 261-5482

Other identifiers 1

IdentifierTypeStateIssuer
0094740MedicaidOH

Other names 1

  • Ms. Susan Louise Haught Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240309000053 OH Practitioner - Qualified Speech Language Pathologist 9931545274 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SP 8302OHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Speech and Hearing Center Speech-Language Pathologist CurrentSince Jan 24, 2024 Accepting new patients

Locations

510 E North Broadway St
Columbus, OH 43214
Phone (614) 263-5151

5155 Bradenton Ave
Ste 150
Dublin, OH 43017
Phone (614) 263-5151

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.

NPI Registry JSON

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

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240531200000",
    "number": "1861648263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 E. NORTH BROADWAY",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432144114",
            "telephone_number": "614-261-5482",
            "fax_number": "614-263-5365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 E. NORTH BROADWAY",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432144114",
            "telephone_number": "614-263-5151",
            "fax_number": "614-263-5365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DABO",
        "first_name": "SUSAN",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-18",
        "last_updated": "2009-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP 8302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0094740",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "HAUGHT",
            "middle_name": "LOUISE",
            "prefix": "MS.",
            "credential": "M.S., CCC-SLP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.