Provider Demographics
NPI:1215925896
Name:ALPHA SPEECH & LANGUAGE CENTER
Entity type:Organization
Organization Name:ALPHA SPEECH & LANGUAGE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEPPARD
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:814-451-0940
Mailing Address - Street 1:2642 GLENWOOD PARK AVE
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16508-1811
Mailing Address - Country:US
Mailing Address - Phone:814-451-0940
Mailing Address - Fax:814-451-0940
Practice Address - Street 1:2642 GLENWOOD PARK AVE
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16508-1811
Practice Address - Country:US
Practice Address - Phone:814-451-0940
Practice Address - Fax:814-451-0940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL002438L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016078130001Medicaid
PA597636OtherUS HEALTHCARE
PA145112OtherHEALTH AMERICA/HEALTH ASS
PAAL486390OtherHIGHMARK BLUE CROSS/BLUE