Provider Demographics
NPI:1467098392
Name:SPEECH START, LLC
Entity Type:Organization
Organization Name:SPEECH START, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNADETTE
Authorized Official - Middle Name:ERIN
Authorized Official - Last Name:MULLEN
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLPD
Authorized Official - Phone:732-888-3912
Mailing Address - Street 1:82 BETHANY RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730
Mailing Address - Country:US
Mailing Address - Phone:732-888-3912
Mailing Address - Fax:732-888-3916
Practice Address - Street 1:21 CEDAR AVE
Practice Address - Street 2:SUITE B1
Practice Address - City:FAIR HAVEN
Practice Address - State:NJ
Practice Address - Zip Code:07704
Practice Address - Country:US
Practice Address - Phone:732-888-3912
Practice Address - Fax:732-888-3916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-26
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1679957997OtherGROUP NPI