NPIMap

Organization Active NPI

Speech and Language Clinic, Inc

  • Speech-Language Pathologist
  • Ammon, ID
National Provider Identifier
1891953519
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP-1147 Issued in ID
Legal business name
SPEECH AND LANGUAGE CLINIC, INC
Practice address
1619 Curlew Dr Ste 5
Ammon, ID 83406-4719
Phone
(208) 535-1286
Fax
(208) 535-1291
NPI assigned
May 29, 2008
Last updated
Mar 28, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2022

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

Authorized official

Name
Mrs. Michelle E Dahlberg, M.ED., CCC-SLPNPI 1255353488
Title
Owner, Speech Pathologist
Phone
(208) 604-1286

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP-1147 ID Primary

Addresses

Primary practice location

1619 Curlew Dr Ste 5
Ammon, ID 83406-4719

Mailing address

1275 South Highline Drive
Idaho Falls, ID 83401
Phone (208) 604-1286

National Provider Directory

National Provider Directory

Locations

1460 Elk Creek Dr
Idaho Falls, ID 83404
Phone (208) 535-1286

Practitioners & affiliated clinicians

Practitioners 101

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 101

NPI Registry JSON

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648425600000",
    "number": "1891953519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 SOUTH HIGHLINE DRIVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83401",
            "telephone_number": "208-604-1286",
            "fax_number": "208-535-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 CURLEW DR STE 5",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834064719",
            "telephone_number": "208-535-1286",
            "fax_number": "208-535-1291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEECH AND LANGUAGE CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-29",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A",
        "authorized_official_last_name": "DAHLBERG",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER, SPEECH PATHOLOGIST",
        "authorized_official_telephone_number": "208-604-1286",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.ED., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "SLP-1147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ammon, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.