Michael John Cusack

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

18602 Issued in OR

Practice address

29781 SW Town Center Loop W Ste 200
Wilsonville, OR 97070-8902

Phone

(503) 946-5375

NPI assigned

Aug 2, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Speech & Play, LLC

  • Speech-Language Pathologist
  • Beaverton, OR
  • NPI 1124421045
  NPD (past)

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

{
    "created_epoch": "1754092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754092800000",
    "number": "1871477950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9255 NE ROCKSPRING ST APT B222",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "970062220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29781 SW TOWN CENTER LOOP W STE 200",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970708902",
            "telephone_number": "503-946-5375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3869 SW Hall Blvd",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970052049",
            "country_code": "US",
            "telephone_number": "503-946-5375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUSACK",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-02",
        "last_updated": "2025-08-02",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "18602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Lynn Crispin, LPC, LMFT ASSOCIATE
• Crossroads Treatment & Counseling Services, Inc
• Ma. Ricca Cuenca
• Gabriel P Currie, M.D.
• Stephen R Curtiss
• Mia Dafinescu
• Jessica Robin Dalcour, D.V.M.
• Anne E Danen, QMHA
• Nicole Daniels
• Kyahn Daraee

• Speech-Language Pathologist in Wilsonville, OR
• Providers in Wilsonville, OR by specialty
• Speech-Language Pathologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2025; 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.