Leslie C Black, M.S.,CCC/SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

13417 Issued in CA

Practice address

1421 Whispering Pines Drive
Scotts Valley, CA 95066

Phone

(831) 204-1908

Fax

(801) 942-5955

NPI assigned

May 16, 2008

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)

Enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1972760015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2460 17TH AVE STE 1041",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950621860",
            "telephone_number": "831-204-1908",
            "fax_number": "801-942-5955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 WHISPERING PINES DRIVE",
            "city": "SCOTTS VALLEY",
            "state": "CA",
            "postal_code": "95066",
            "telephone_number": "831-204-1908",
            "fax_number": "801-942-5955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "LESLIE",
        "middle_name": "C",
        "credential": "M.S.,CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-16",
        "last_updated": "2022-03-11",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "13417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Scotts Valley, CA
• Providers in Scotts Valley, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; 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.