Active NPI
Brenna Linscott Gonsalves, CCC-SLP
- Speech-Language Pathologist
- Hattiesburg, MS
National Provider Identifier
1992262430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 13325
- Practice address
- 6051 U S Highway 49
Hattiesburg, MS 39401-7200 - Phone
- (601) 288-7000
- NPI assigned
- Feb 20, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 13325 | NC | Primary |
Addresses
Primary practice location
6051 U S Highway 49
Hattiesburg, MS 39401-7200
Mailing address
75 Cross Creek Pkwy Apt 5304
Hattiesburg, MS 39402-4456
Phone (508) 463-6002
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13325 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550620800000",
"number": "1992262430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 CROSS CREEK PKWY APT 5304",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394024456",
"telephone_number": "508-463-6002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6051 U S HIGHWAY 49",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394017200",
"telephone_number": "601-288-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONSALVES",
"first_name": "BRENNA",
"middle_name": "LINSCOTT",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-02-20",
"last_updated": "2019-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "13325",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hattiesburg, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.