Mary Catherine Samuel, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

105223 Issued in MO

Practice address

6929 Wise Ave
Saint Louis, MO 63139-3731

Phone

(314) 297-8008

NPI assigned

Nov 20, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Mary Catherine McAllister Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bricks and Bites LLC

  • Occupational Therapist
  • Saint Louis, MO
  • NPI 1023626983

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1972106821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6929 WISE AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631393731",
            "telephone_number": "314-312-2984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6929 WISE AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631393731",
            "telephone_number": "314-297-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "MARY",
        "middle_name": "CATHERINE",
        "name_prefix": "Mrs.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-20",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "105223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "MCALLISTER",
            "middle_name": "CATHERINE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ramulu Samudrala, P.C
• Siresha Kiran Samudrala, M.D.
• Suseela Samudrala, M.D.
• Samuel Lugo M.D., F.a.C.S.
• Chardial Samuel, LCSW
• Amanda Samuels, LPC
• Erin K. Samuels, M.D.
• Whitney Samuels
• Shushanna Samvelian, MD
• San Francisco Temple Multiplex

• Speech-Language Pathologist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Speech-Language Pathologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; 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.