1790053379 NPI number — TESSA M ANDERSON M.S., CCC-SLP

Table of content: TESSA M ANDERSON M.S., CCC-SLP (NPI 1790053379)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790053379 NPI number — TESSA M ANDERSON M.S., CCC-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ANDERSON
Provider First Name:
TESSA
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.S., CCC-SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HOWSDEN
Provider Other First Name:
TESSA
Provider Other Middle Name:
M
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1790053379
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/11/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
HEARTLAND SPEECH & LANGUAGE SERVICES, P.C.
Provider Second Line Business Mailing Address:
1651 N. 86TH ST., SUITE 200
Provider Business Mailing Address City Name:
LINCOLN
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68505-3719
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-327-2500
Provider Business Mailing Address Fax Number:
402-327-2525

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3011 FLETCHER AVE
Provider Second Line Business Practice Location Address:
APT. 169
Provider Business Practice Location Address City Name:
LINCOLN
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68504-1033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
308-233-4259
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/09/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  1471 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 235Z00000X , with the licence number: 1470 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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