Individual provider Active NPI

Charlene Wilhelmsen

  • Speech-Language Assistant
  • Chandler, AZ
National Provider Identifier
1962185603
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
SLPA14507 Issued in AZ
Practice address
670 N Arizona Ave
Chandler, AZ 85225-6741
Phone
(480) 963-2313
NPI assigned
Aug 9, 2023
Last updated
Aug 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X SLPA14507 AZ Primary

Addresses

Primary practice location

670 N Arizona Ave
Chandler, AZ 85225-6741

Mailing address

22659 E Parkside Dr
Queen Creek, AZ 85142-9507
Phone (208) 991-8275

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

LicenseStateTypeSpecialty
SLPA14507AZMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1962185603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22659 E PARKSIDE DR",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851429507",
            "telephone_number": "208-991-8275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 N ARIZONA AVE",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852256741",
            "telephone_number": "480-963-2313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILHELMSEN",
        "first_name": "CHARLENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-09",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "AZ",
            "license": "SLPA14507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

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