Christine Frances Cicci, SPEECH LANGUAGE PATH

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

401 E Front St Ste 123
Tyler, TX 75702-8250

Phone

(903) 531-2581

NPI assigned

Nov 29, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1480377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1952844516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E FRONT ST STE 123",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757028250",
            "telephone_number": "903-531-2581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E FRONT ST STE 123",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757028250",
            "telephone_number": "903-531-2581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICCI",
        "first_name": "CHRISTINE",
        "middle_name": "FRANCES",
        "credential": "SPEECH LANGUAGE PATH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-29",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "903852",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "12204",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "4819",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4317679",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Tyler, TX
• Providers in Tyler, 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 Jan 24, 2023; 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.