Individual provider Active NPI

Caitlyn Dehaan

  • Speech-Language Pathologist
  • Jenison, MI
National Provider Identifier
1861973976
Registry record updated Mar 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101005857 Issued in MI
Practice address
7086 8TH Ave
Jenison, MI 49428-9352
Phone
(616) 667-9551
NPI assigned
Aug 27, 2018
Last updated
Mar 17, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2019

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 7101005857 MI Primary

Addresses

Primary practice location

7086 8TH Ave
Jenison, MI 49428-9352

Mailing address

75 E 22ND St
Holland, MI 49423-4811

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

State licenses

LicenseStateTypeSpecialty
7101005857MIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552780800000",
    "number": "1861973976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 E 22ND ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7086 8TH AVE",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494289352",
            "telephone_number": "616-667-9551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHAAN",
        "first_name": "CAITLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-27",
        "last_updated": "2019-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101005857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jenison, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2019; 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.