Mary Kate Sheridan, MS. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

4222 Issued in AR

Practice address

609 W Maple Ave # 2600
Springdale, AR 72764-5335

Phone

(479) 757-2600

NPI assigned

Apr 3, 2023

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1992400477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 MCGUIRE ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727621626",
            "telephone_number": "479-841-5131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 W MAPLE AVE # 2600",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727645335",
            "telephone_number": "479-757-2600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "609 W Maple Ave # 2300",
            "address_purpose": "LOCATION",
            "city": "Springdale",
            "state": "AR",
            "postal_code": "727645394",
            "country_code": "US",
            "telephone_number": "479-757-2300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHERIDAN",
        "first_name": "MARY",
        "middle_name": "KATE",
        "credential": "MS. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "4222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Springdale, AR
• Speech-Language Pathologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; 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.