MEDICARE: COURTNEY ADDINGTON M.A.,CCC/SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SP.11164	OH
2	235Z00000X	Speech-Language Pathologist	SA13771	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346649233
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY ADDINGTON M.A.,CCC/SLP

Provider Business Mailing Address
First Line	:	1651 STIMMEL ST
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34286-5214
Country	:	US
Telephone Number	:	330-546-4787
Fax Number	:

Provider Business Practice Location Address
First Line	:	1651 STIMMEL ST
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34286-5214
Country	:	US
Telephone Number	:	330-546-4787
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2014
Last Update Date	:	07/27/2022

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Directions to “ COURTNEY ADDINGTON M.A.,CCC/SLP” Practice Location

Language	Start Address	Practice Location

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