Traci A. Smallwood, MA CCC SLP
NPI 1609099647ActiveIndividual· Speech-Language Pathologist· Plymouth, MN
Speech-Language Pathologist (MA CCC SLP) in Plymouth, Minnesota, licensed in MN, with an NPI issued in April 2007. Enrolled in Medicare as practitioner - qualified speech language pathologist.
Overview
| NPI | 1609099647 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MA CCC SLP |
| Sole proprietor | No |
| NPI issued | Apr 10, 2007 |
| Last updated in NPPES | Sep 22, 2025 |
| Certified by provider | Sep 22, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Speech-Language Pathologist Primary | 235Z00000X | LICC-247 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Qualified Speech Language Pathologist (MN) |
|---|
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