Healthcare Provider Details

I. General information

NPI: 1164280848
Provider Name (Legal Business Name): BEYOND SPEECH SOUTH SHORE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2024
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 COUNTRY WAY
SCITUATE MA
02066-3744
US

IV. Provider business mailing address

129 COUNTRY WAY
SCITUATE MA
02066-3709
US

V. Phone/Fax

Practice location:
  • Phone: 508-340-3106
  • Fax:
Mailing address:
  • Phone: 508-340-3106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: KATHRYN JONES
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential: M.S., CCC-SLP
Phone: 508-340-3106