Jerilyn Elissa Agness, M.S. CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Covington, LA
NPI 1992003107 · NPPES record last updated Mar 22, 2018
Key facts
- NPI
- 1992003107
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 6595 (LA)
- Practice address
- 5001 Highway 190 East Service Rd Ste D6
Covington, LA 70433-4956 - Phone
- (985) 805-2555
- Fax
- (985) 400-5303
- NPI assigned
- Mar 11, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA9847 | FL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Language Learners, LLC | Speech-Language Pathologist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 6595 | LA | Yes |
| Speech-Language Pathologist | 235Z00000X | SA9847 | FL |
Addresses
Primary practice location
5001 Highway 190 East Service Rd Ste D6
Covington, LA 70433-4956
Mailing address
PO Box 1609
Chalmette, LA 70044-1609
Phone (985) 805-2555
Other practice location 1
1544 Canal St
Lehigh Acres, FL 33936-5300
Phone (239) 225-3682
Other practice location 2
330 Falconer Dr Ste D-F
Covington, LA 70433-8210
Phone (985) 805-2555
Other providers in Covington, LA
- Amita Vyomesh Adhvaryu
- Administrators of the Tulane Educational Fund
- Farhad X Aduli
- Advanced Northshore Neurosurgical Institute
- Aerosol Plus, Inc.
- Amie Aguillard
- Allie Ainsworth
- Shanti Akasapu
- Al IV Enterprises Inc
- Crystal Alack
All providers in Covington, LA · Speech-Language Pathologist in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.