Kim De La Rosa, MACCCSLP
NPI 1699130187ActiveIndividual· Speech-Language Pathologist· St Johnsbury, VT
Speech-Language Pathologist (MACCCSLP) in St Johnsbury, Vermont, licensed in VT, with an NPI issued in December 2015.
Overview
| NPI | 1699130187 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MACCCSLP |
| Sole proprietor | Yes |
| NPI issued | Dec 28, 2015 |
| Last updated in NPPES | Dec 28, 2015 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Speech-Language Pathologist Primary | 235Z00000X | 8045629 | VT |
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) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other Speech-Language Pathologist providers in St Johnsbury
- 1346173796
- 1154105518
- 1558039818