Stacie Maree Clay, MA,CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

22004452A Issued in IN

Practice address

6701 South Anthony Blvd.
Fort Wayne, IN 46816-2035

Phone

(260) 447-1591

NPI assigned

Apr 3, 2012

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

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": "1333411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333411200000",
    "number": "1962768077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5148 INDIANOLA AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462051229",
            "telephone_number": "317-366-5084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 SOUTH ANTHONY BLVD.",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468162035",
            "telephone_number": "260-447-1591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAY",
        "first_name": "STACIE",
        "middle_name": "MAREE",
        "credential": "MA,CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-03",
        "last_updated": "2012-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22004452A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saymara Re'Nay Clauss
• Alissa Lynn Clawson, CRNA
• Nikki Clawson, RBT
• Belinda Claxton
• Margaret Clay
• Samantha Marie Claymiller, RRT
• Jacob Thaddeus Clayton, LCSW
• Ronae Cleland, CLS
• Allison Catherine Clemens, PHARMD
• Lisa M Clemens, P.A.

• Speech-Language Pathologist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Speech-Language Pathologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; 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.