NPIMap

Individual provider Active NPI

Elisabeth Sue Swanson, SLP

  • Speech-Language Pathologist
  • Avon, CT
National Provider Identifier
1912546771
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
5894 Issued in CT
Practice address
30 Avon Meadow LN
Avon, CT 06001-3745
Phone
(860) 284-9779
Fax
(860) 409-2190
NPI assigned
Dec 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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 5894 CT Primary

Addresses

Primary practice location

30 Avon Meadow LN
Avon, CT 06001-3745

Mailing address

30 Avon Meadow LN
Avon, CT 06001-3745
Phone (860) 284-9779

Other practice location 1

10 George Ave
Cheshire, CT 06410-2570
Phone (203) 250-9663

Other names 1

  • Elizabeth Nicoletti Former name

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

Practice roles

OrganizationSpecialtyStatusNew patients
Joyful Noise Therapy Services Speech-Language Pathologist Current Accepting new patients
Cheshire Fitness Zone, LLC Speech-Language Pathologist PastSince Jul 5, 2020 Accepting new patients
Creative Development, LLC Speech-Language Pathologist PastSince Dec 29, 2019 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1577404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1912546771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 AVON MEADOW LN",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013745",
            "telephone_number": "860-284-9779",
            "fax_number": "860-409-2190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 AVON MEADOW LN",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013745",
            "telephone_number": "860-284-9779",
            "fax_number": "860-409-2190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 George Ave",
            "address_purpose": "LOCATION",
            "city": "Cheshire",
            "state": "CT",
            "postal_code": "064102570",
            "country_code": "US",
            "telephone_number": "203-250-9663",
            "fax_number": "203-699-9641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "ELISABETH",
        "middle_name": "SUE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-27",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CT",
            "license": "5894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "NICOLETTI",
            "credential": "SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jun 5, 2023; 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.