Elizabeth M Desantis-Correa, MS CCC SLP
Individual provider Active NPI Speech-Language Pathologist · Redding, CT
NPI 1912492018 · NPPES record last updated Aug 18, 2023
Key facts
- NPI
- 1912492018
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 5026 (CT)
- Practice address
- 59 Deer Hill Rd
Redding, CT 06896-2312 - Phone
- (203) 993-5711
- NPI assigned
- Jun 30, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240626003106 | CT | Practitioner - Qualified Speech Language Pathologist | 7214471614 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 5026 | CT | Yes |
Addresses
Primary practice location
59 Deer Hill Rd
Redding, CT 06896-2312
Mailing address
59 Deer Hill Rd
Redding, CT 06896-2312
Phone (203) 993-5711
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All providers in Redding, CT · Speech-Language Pathologist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.