Julie Kristin Elliott, M.A. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

42842 Lombardy Dr
Canton, MI 48187-2321

Phone

(734) 436-1980

NPI assigned

Jun 9, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Julie Kristin Bennett Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1654732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1932838372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42842 LOMBARDY DR",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872321",
            "telephone_number": "734-436-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42842 LOMBARDY DR",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872321",
            "telephone_number": "734-436-1980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "JULIE",
        "middle_name": "KRISTIN",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-09",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.north42degreestherapy.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "42842 Lombardy Dr",
            "city": "Canton",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481872321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "BENNETT",
            "middle_name": "KRISTIN",
            "credential": "MA CCC-SLPK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Speech-Language Pathologist in Canton, MI
• Providers in Canton, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.