Jacqueline Lee Smith, M.A. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP5393 Issued in AZ

Practice address

140 S Gilbert Rd
Gilbert, AZ 85296-1016

Phone

(480) 497-3300

NPI assigned

Sep 4, 2007

Last updated

Apr 30, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jacqueline Lee Miller Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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.

• Soar Health, Inc.

  dba Soar Autism Center

  • Behavior Analyst
  • Denver, CO
  • NPI 1437751252

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1881888790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4222 E VEST AVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852956144",
            "telephone_number": "630-631-8343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 S GILBERT RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852961016",
            "telephone_number": "480-497-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 N. Anthem Way",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "AZ",
            "postal_code": "85232",
            "country_code": "US",
            "telephone_number": "520-723-6400 x3074",
            "fax_number": "520-723-0124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACQUELINE",
        "middle_name": "LEE",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-04",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP5393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "MILLER",
            "middle_name": "LEE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Euly Cecille Smith
• Gary A Smith, M.D.
• Gregory P Smith, DDS
• Heather Annette Smith, FNP-C
• Jacqueline Smith
• James Smith, M.D.
• Jennifer Smith, FNP-C
• Jennifer Marie Smith, OTD, OTR/L
• John Andrew Smith, RN
• Kerrie Nona Smith, SLPA

• Speech-Language Pathologist in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Speech-Language Pathologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; 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.