Active NPI
Andrea Braverman, M.S. CCC-SLP
- Speech-Language Pathologist
- Church Hill, MD
National Provider Identifier
1881165348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 06001
- Practice address
- 631 Main St
Church Hill, MD 21623-1201 - Phone
- (410) 556-6103
- Fax
- (410) 556-6035
- NPI assigned
- Dec 10, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 06001 | MD | Primary |
Addresses
Primary practice location
631 Main St
Church Hill, MD 21623-1201
Mailing address
105 Seymour Ave
St Michaels, MD 21663-2931
Phone (410) 443-1914
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06001 | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544400000000",
"number": "1881165348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 SEYMOUR AVE",
"city": "ST MICHAELS",
"state": "MD",
"postal_code": "216632931",
"telephone_number": "410-443-1914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "631 MAIN ST",
"city": "CHURCH HILL",
"state": "MD",
"postal_code": "216231201",
"telephone_number": "410-556-6103",
"fax_number": "410-556-6035"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAVERMAN",
"first_name": "ANDREA",
"credential": "M.S. CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-10",
"last_updated": "2018-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MD",
"license": "06001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Church Hill, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.