Individual provider Active NPI

Chanel Mercedes Morris-Stephens, M.A.

  • Speech-Language Pathologist
  • Lake Worth, FL
National Provider Identifier
1861962169
Registry record updated Dec 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA14887 Issued in FL
Practice address
5635 Green Island Blvd
Lake Worth, FL 33463-7352
Phone
(770) 714-0642
NPI assigned
Nov 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2018

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 SA14887 FL Primary

Addresses

Primary practice location

5635 Green Island Blvd
Lake Worth, FL 33463-7352

Mailing address

5635 Green Island Blvd
Lake Worth, FL 33463-7352
Phone (770) 714-0642

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)
Enrolled
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1543449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544918400000",
    "number": "1861962169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5635 GREEN ISLAND BLVD",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334637352",
            "telephone_number": "770-714-0642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5635 GREEN ISLAND BLVD",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334637352",
            "telephone_number": "770-714-0642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS-STEPHENS",
        "first_name": "CHANEL",
        "middle_name": "MERCEDES",
        "name_prefix": "Mrs.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-29",
        "last_updated": "2018-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA14887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2018; 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.