Individual provider Active NPI

Liliana Petrov

  • Speech-Language Pathologist
  • Avon, CT
National Provider Identifier
1891581013
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8073 Issued in CT
Practice address
136 Simsbury Rd
Avon, CT 06001-3760
Phone
(860) 608-7366
NPI assigned
Apr 15, 2025
Last updated
Apr 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 8073 CT Primary

Addresses

Primary practice location

136 Simsbury Rd
Avon, CT 06001-3760

Mailing address

45 Westwood Dr
Simsbury, CT 06070-1719

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

State licenses

LicenseStateTypeSpecialty
8073CTMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Speakology LLC Speech-Language Pathologist PastSince Apr 20, 2025 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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": "1891581013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 WESTWOOD DR",
            "city": "SIMSBURY",
            "state": "CT",
            "postal_code": "060701719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 SIMSBURY RD",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013760",
            "telephone_number": "860-608-7366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROV",
        "first_name": "LILIANA",
        "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": "CT",
            "license": "8073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, CT

Sources for this page

  • 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.