Active NPI
Carissa Stevens, SP/L
- Speech-Language Pathologist
- Camden Wyoming, DE
National Provider Identifier
1952563637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- O4-0000255
- Practice address
- 278 Sorghum Mill Rd
Camden Wyoming, DE 19934-1935 - Phone
- (302) 697-3103
- Fax
- (302) 697-4998
- NPI assigned
- Jun 25, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | O4-0000255 | DE | Primary |
Addresses
Primary practice location
278 Sorghum Mill Rd
Camden Wyoming, DE 19934-1935
Mailing address
278 Sorghum Mill Rd
Camden Wyoming, DE 19934-1935
Phone (302) 697-3103
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| O4-0000255 | DE | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214352000000",
"number": "1952563637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "278 SORGHUM MILL RD",
"city": "CAMDEN WYOMING",
"state": "DE",
"postal_code": "199341935",
"telephone_number": "302-697-3103",
"fax_number": "302-697-4998"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "278 SORGHUM MILL RD",
"city": "CAMDEN WYOMING",
"state": "DE",
"postal_code": "199341935",
"telephone_number": "302-697-3103",
"fax_number": "302-697-4998"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEVENS",
"first_name": "CARISSA",
"credential": "SP/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-25",
"last_updated": "2008-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "DE",
"license": "O4-0000255",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camden Wyoming, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.