Individual provider Active NPI

Stefanie Peck, M.A. CCC-SLP

  • Speech-Language Pathologist
  • Solon, OH
National Provider Identifier
1972654747
Registry record updated Apr 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP6712 Issued in OH
Practice address
6325 Cochran Rd Ste 2
Solon, OH 44139-3930
Phone
(440) 498-1100
Fax
(440) 498-1100
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 6712 OH
Speech-Language Pathologist 235Z00000X SP6712 OH Primary

Addresses

Primary practice location

6325 Cochran Rd Ste 2
Solon, OH 44139-3930

Mailing address

6325 Cochran Rd Ste 2
Solon, OH 44139-3930
Phone (440) 498-1100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stefanie@center4lifeskills.com Direct

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6712OHMDSpeech-Language Pathologist
SP6712OHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Center for Lifeskills, LLC Single Specialty CurrentSince Nov 8, 2020 Accepting new patients
Stefanie J. Peck, M.a. CCC-SLP CurrentSince Nov 8, 2020 Accepting new patients

Locations

31005 Bainbridge Rd
Ste 7
Solon, OH 44139
Phone (440) 489-1100

6325 Cochran Rd
Ste 2
Solon, OH 44139
Phone (440) 498-1100

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586217600000",
    "number": "1972654747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6325 COCHRAN RD STE 2",
            "city": "SOLON",
            "state": "OH",
            "postal_code": "441393930",
            "telephone_number": "440-498-1100",
            "fax_number": "440-498-1149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6325 COCHRAN RD STE 2",
            "city": "SOLON",
            "state": "OH",
            "postal_code": "441393930",
            "telephone_number": "440-498-1100",
            "fax_number": "440-498-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "STEFANIE",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "6712",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP6712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stefanie@center4lifeskills.com",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "not sure",
            "address_1": "6325 Cochran Rd Ste 2",
            "city": "Solon",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441393930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Solon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.