Thao Hanh Witbeck, MS, CCC-SLP/L

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

2251 E Paris Ave SE
Grand Rapids, MI 49546-2431

Phone

(616) 447-7799

Fax

(616) 724-4117

NPI assigned

May 19, 2014

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

Other names 1

• Thao Hanh DO Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Pediatric Interactions

  • Early Intervention Provider Agency
  • Grayslake, IL
  • NPI 1568912277
  NPD (past)
• Pediatric Interactions Inc

  • Speech-Language Pathologist
  • Grayslake, IL
  • NPI 1740404433
  NPD (past)

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1992116339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 N OTTILLIA ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495073738",
            "telephone_number": "847-322-7465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2251 E PARIS AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462431",
            "telephone_number": "616-447-7799",
            "fax_number": "616-724-4117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITBECK",
        "first_name": "THAO",
        "middle_name": "HANH",
        "name_prefix": "Mrs.",
        "credential": "MS, CCC-SLP/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-19",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THAO",
            "last_name": "DO",
            "middle_name": "HANH",
            "credential": "MS, CCC-SLP/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Luke Wisniewski, DO
• Mary L Wisniewski, PA-C
• Rachel Wisniewski, OTR
• Sydney Wisniewski, LLMSW
• Heather Wiszczur-Johnson, LMSW, CAADC
• David Bryan Witcher, MD
• Andrea Nicole Witczak, RN
• With Purpose Counseling
• Gayle Witham
• Robert B Witham, RPH

• Speech-Language Pathologist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.