Provider Demographics
NPI:1588806988
Name:MCCONACHIE, STCAEY J (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:STCAEY
Middle Name:J
Last Name:MCCONACHIE
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11096 W 55TH LN
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-4906
Mailing Address - Country:US
Mailing Address - Phone:218-791-5286
Mailing Address - Fax:
Practice Address - Street 1:11096 W 55TH LN
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-4906
Practice Address - Country:US
Practice Address - Phone:218-791-5286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-31
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
12094774235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist