NPI Code Detail JSON Logo

1801410162 NPI number — MICHELLE ELIZABETH VICTORIA FORBES MS CCC-SLP/L

NPI Number: 1801410162
Health Care Provider/Practitioner: MICHELLE ELIZABETH VICTORIA FORBES MS CCC-SLP/L

Information about “1801410162” NPI (MICHELLE ELIZABETH VICTORIA FORBES MS CCC-SLP/L) exists in 1801410162 in HTML format HTML  |  1801410162 in plain Text format TXT  |  1801410162 in PDF (Portable Document Format) PDF  |  1801410162 in an XML format XML  formats.

NPI Number : 1801410162 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1801410162",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "FORBES",
    "FirstName": "MICHELLE",
    "MiddleName": "ELIZABETH VICTORIA",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MS CCC-SLP/L",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "ESCUE",
    "OtherFirstName": "MICHELLE",
    "OtherMiddleName": "ELIZABETH VICTORIA",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "MS CCC-SLP/L",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1406 FAYETTE AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WASHINGTON",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "61571-1122",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "309-472-1347",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1406 FAYETTE AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WASHINGTON",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "61571-1122",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "309-472-1347",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/02/2020",
    "LastUpdateDate": "08/06/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "235Z00000X",
          "TaxonomyName": "Speech-Language Pathologist",
          "LicenseNumber": "8414",
          "LicenseNumberStateCode": "TN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "235Z00000X",
          "TaxonomyName": "Speech-Language Pathologist",
          "LicenseNumber": "146.016010",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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