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NPI 1285415091ActiveIndividual· Speech-Language Pathologist· Massillon, OH
Speech-Language Pathologist in Massillon, Ohio, licensed in OH, with an NPI issued in October 2023. Enrolled in Medicare as practitioner - qualified speech language pathologist.
Overview
| NPI | 1285415091 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | Oct 9, 2023 |
| Last updated in NPPES | Feb 9, 2026 |
| Certified by provider | Feb 9, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Speech-Language Pathologist Primary | 235Z00000X | SP.16197 | OH |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Qualified Speech Language Pathologist (OH) |
|---|
Education and affiliations
| Graduation year | 2023 |
|---|---|
| Medicare specialty | Qualified Speech Language Pathologist |
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