1689682023 NPI number — THOMPSON SPEECH THERAPY, LLC

Table of content: (NPI 1689682023)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689682023 NPI number — THOMPSON SPEECH THERAPY, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THOMPSON SPEECH THERAPY, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689682023
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/27/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3A BLACK DUCK CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEWBURY
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01951-2300
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-499-9970
Provider Business Mailing Address Fax Number:
978-477-0467

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3A BLACK DUCK CIR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWBURY
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01951-2300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-499-9970
Provider Business Practice Location Address Fax Number:
978-477-0467
Provider Enumeration Date:
08/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BRITT-THOMPSON
Authorized Official First Name:
MICHELLE
Authorized Official Middle Name:
M
Authorized Official Title or Position:
SPEECH-LANGUAGE PATHOLOGIST
Authorized Official Telephone Number:
978-499-9970

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  5243 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 9377169 . This is a "PRIVATE HEALTH CARE (PHCS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 448871 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: SP0125 . This is a "BLUE CROSS OF MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: AA31786 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 7426634 . This is a "AETNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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