Organization Active NPI

Mindful Speech Solutions LLC

  • Speech-Language Pathologist
  • Saint Clair Shores, MI
National Provider Identifier
1891452017
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
MINDFUL SPEECH SOLUTIONS LLC
Practice address
22444 Downing St
Saint Clair Shores, MI 48080-2846
Phone
(810) 887-1363
NPI assigned
Nov 22, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Authorized official

Name
Kala Wagner
Title
Speech-Language Pathologist/Owner
Phone
(810) 887-1363

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

22444 Downing St
Saint Clair Shores, MI 48080-2846

Mailing address

22444 Downing St
Saint Clair Shores, MI 48080-2846
Phone (810) 887-1363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220211002048 MI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7315330800 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Clair Shores, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637539200000",
    "number": "1891452017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22444 DOWNING ST",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802846",
            "telephone_number": "810-887-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22444 DOWNING ST",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802846",
            "telephone_number": "810-887-1363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL SPEECH SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-22",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "KALA",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST/OWNER",
        "authorized_official_telephone_number": "810-887-1363"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.