Sugar Plum Speech LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SL008632 Issued in PA

Legal business name

SUGAR PLUM SPEECH LLC

Practice address

2937 Route 611 Unit 15
Tannersville, PA 18372

Phone

(570) 236-8380

Fax

(570) 355-4097

NPI assigned

May 22, 2014

Organization subpart

No

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

Authorized official

Name

Jessica Lyn Gibbons, MA CCC-SLPNPI 1356517460

Title

Owner

Phone

(570) 236-8380

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jessica Lyn Gibbons, M.A. CCC-SLP

  • Speech-Language Pathologist
  • Tannersville, PA
  • NPI 1356517460

  Multi-Specialty

  NPD (past) Authorized official

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

{
    "created_epoch": "1400716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672876800000",
    "number": "1871905059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 852",
            "city": "TANNERSVILLE",
            "state": "PA",
            "postal_code": "183720852",
            "telephone_number": "570-236-8380",
            "fax_number": "570-355-4097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2937 ROUTE 611 UNIT 15",
            "city": "TANNERSVILLE",
            "state": "PA",
            "postal_code": "18372",
            "telephone_number": "570-236-8380",
            "fax_number": "570-355-4097"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2071 Route 209",
            "address_purpose": "LOCATION",
            "city": "Brodheadsville",
            "state": "PA",
            "postal_code": "18322",
            "country_code": "US",
            "telephone_number": "570-236-8380",
            "fax_number": "570-355-4097",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2071 Route 209",
            "address_purpose": "LOCATION",
            "city": "Brodheadsville",
            "state": "PA",
            "postal_code": "18322",
            "country_code": "US",
            "telephone_number": "570-236-8380",
            "fax_number": "570-355-4097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUGAR PLUM SPEECH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-22",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A",
        "authorized_official_last_name": "GIBBONS",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "LYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-236-8380",
        "authorized_official_credential": "MA CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL008632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Tannersville, PA
• Providers in Tannersville, PA by specialty
• Speech-Language Pathologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.