Mary Eller, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

14362580 Issued in TX

Practice address

600 N Ellison Dr
San Antonio, TX 78251-4345

Phone

(210) 397-6450

NPI assigned

Jul 7, 2022

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

State licenses

Practice roles

Locations

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.

• Freedom of Speechies, PLLC.

  • Speech-Language Pathologist
  • San Antonio, TX
  • NPI 1497539704
  NPD Authorized official

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

{
    "created_epoch": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1891428736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6915 QUANTUM LOOP",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782524444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N ELLISON DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782514345",
            "telephone_number": "210-397-6450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLER",
        "first_name": "MARY",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-07",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "14362580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Elledge, MD
• Ellen Boyle Duncan PLLC
• Ellen W Lin MD PA
• Phyllis Jean Ellena, ADVANCED PRACTICE RN
• Leslie Ann Ellenbogen, L.C.S.W.-A.C.P.
• Sonja Kristina Ellerbee, MSN, APRN, NP-C
• Jan Rochelle Elleson, M.A., CCC-SLP
• Gaylord Elling, D.D.S
• Matthew Allan Ellinger Jr.
• Wendy Elliot

• Speech-Language Pathologist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; 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.