Kimberly Brabham, MS, CCC-SLP, L-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

6178 Issued in LA

Practice address

30298 Deaux Run
Albany, LA 70711-2843

Phone

(225) 715-6031

NPI assigned

Feb 22, 2021

Last updated

Feb 22, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1613952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1922692912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30298 DEAUX RUN",
            "city": "ALBANY",
            "state": "LA",
            "postal_code": "707112843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30298 DEAUX RUN",
            "city": "ALBANY",
            "state": "LA",
            "postal_code": "707112843",
            "telephone_number": "225-715-6031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRABHAM",
        "first_name": "KIMBERLY",
        "credential": "MS, CCC-SLP, L-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-22",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "LA",
            "license": "6178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LBESPA",
            "identifier": "6178",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Albany",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "30298 Deaux Run",
            "city": "Albany",
            "state": "LA",
            "country_code": "US",
            "postal_code": "707112843",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Speech-Language Pathologist in Albany, LA
• Providers in Albany, LA by specialty
• Speech-Language Pathologist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2021; 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.