Madelynn Alexandra Main, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

28109 Issued in CA

Practice address

2017 Palo Verde Ave Ste 201
Long Beach, CA 90815-3300

Phone

(562) 317-1477

NPI assigned

Apr 15, 2025

Sex

Female

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

Credentials

Master of Science

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Supernova Speech Therapy, a Professional Speech Language Pathology Cor

  • Speech-Language Pathologist
  • Long Beach, CA
  • NPI 1053027441
  NPD (past)

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

{
    "created_epoch": "1744675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1881480218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5130 E ANAHEIM RD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908154221",
            "telephone_number": "562-833-5466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2017 PALO VERDE AVE STE 201",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908153300",
            "telephone_number": "562-317-1477"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5130 E Anaheim Rd",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908154221",
            "country_code": "US",
            "telephone_number": "562-833-5466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAIN",
        "first_name": "MADELYNN",
        "middle_name": "ALEXANDRA",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-15",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "28109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phuong Mai
• Sean T Mai, DOCTOR OF PHARMACY
• Christiana Maiella, FNP
• Christa Maikisch
• Henry Maillefer, PHARM.D.
• Susan Mais-Requejo, D.P.T.
• Jill E. Maiten, NURSE PRACTITIONER
• Christine M. Maitland-Koeh, M.S.W.
• Michael Paul Majancsik, D.C.
• Majestic Medical Clinic, Inc.

• Speech-Language Pathologist in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.