Christa Lynne Konderla, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

18283 Issued in TX

Practice address

1812 Welsh Ave
College Station, TX 77840-4800

Phone

(979) 764-5433

Fax

(979) 764-5489

NPI assigned

Sep 13, 2021

Last updated

Sep 13, 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 names 1

• Christa Lynne Wade Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1952070989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 WELSH AVE",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778404800",
            "telephone_number": "979-764-5433",
            "fax_number": "979-764-5489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 WELSH AVE",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778404800",
            "telephone_number": "979-764-5433",
            "fax_number": "979-764-5489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONDERLA",
        "first_name": "CHRISTA",
        "middle_name": "LYNNE",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-13",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "18283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTA",
            "last_name": "WADE",
            "middle_name": "LYNNE",
            "credential": "MA, CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elizabeth Cunningham Klemm, PT, MPH
• Daniel Alton Kniffin, A.T.C., L.A.T.
• Kristopher David Knoop, M.D.
• Allyson Koger
• Claire Macpherson Kolb, PA-C
• Hayden Wade Kopetsky, PHARM. D
• Deena Kothmann, FNP
• Joseph W Kraft, MD
• Jessica Anne Kral
• Allison Kraus-Saravia

• Speech-Language Pathologist in College Station, TX
• Providers in College Station, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.