Stanley Mark Swentkowski, M.C.D., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

S0139 Issued in MS

Practice address

1742 Cheryl St
Clarksdale, MS 38614-7218

Phone

(662) 627-5247

Fax

(662) 627-1739

NPI assigned

Oct 2, 2006

Sex

Male

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1952494056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 182",
            "address_2": "1742 CHERYL STREET",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386140182",
            "telephone_number": "662-627-5247",
            "fax_number": "662-627-1739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1742 CHERYL ST",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386147218",
            "telephone_number": "662-627-5247",
            "fax_number": "662-627-1739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWENTKOWSKI",
        "first_name": "STANLEY",
        "middle_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "M.C.D., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S0139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00120102",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Clarksdale, MS
• Providers in Clarksdale, MS by specialty
• Speech-Language Pathologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.