Colette Ellis M.Ed., CCC-SLP & Associates

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

327 Issued in OK

Legal business name

COLETTE ELLIS M.ED., CCC-SLP & ASSOCIATES

Doing business as

29th Street Therapy Center

Practice address

1211 S 29TH St
Chickasha, OK 73018-9651

Phone

(405) 224-0002

Fax

(405) 224-0133

NPI assigned

Feb 19, 2008

Last updated

Feb 19, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Colette L. Ellis, M.ED., CCC-SLPNPI 1043364458

Title

Speech-Language Pathologist

Phone

(405) 224-0002

Specialties & licenses 1

Addresses

Other names 1

• 29th Street Therapy Center Doing business as

Locations

Practitioners 1

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.

• Colette Leonie Ellis, M.ED.,CCC-SLP

  • Speech-Language Pathologist
  • Chickasha, OK
  • NPI 1043364458
  Authorized official Same address or phone

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203379200000",
    "number": "1891963278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 S 29TH ST",
            "city": "CHICKASHA",
            "state": "OK",
            "postal_code": "730189651",
            "telephone_number": "405-224-0002",
            "fax_number": "405-224-0133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 S 29TH ST",
            "city": "CHICKASHA",
            "state": "OK",
            "postal_code": "730189651",
            "telephone_number": "405-224-0002",
            "fax_number": "405-224-0133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLETTE ELLIS M.ED., CCC-SLP & ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-19",
        "last_updated": "2008-02-19",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "COLETTE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "405-224-0002",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.ED., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "29th Street Therapy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jason Clemons
• Christen Roberson Clift, O.D.
• Kylee Clift
• Janice Cockrum
• Thomas H. Coe, M.D.
• Convalescent Center of Grady County (Grace Living Center - Chickasha)
• Tara Diane Conway, MS, RDLD
• Mitchell D Coppedge, MD
• Raymond L Cornelison, MD
• Kayla Dawhn Cornett

• Speech-Language Pathologist in Chickasha, OK
• Providers in Chickasha, OK by specialty
• Speech-Language Pathologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; 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.