Provider Demographics
NPI:1689899395
Name:PROGRESSIVE SPEECH, LLC
Entity Type:Organization
Organization Name:PROGRESSIVE SPEECH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:K
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-789-9537
Mailing Address - Street 1:PO BOX 97
Mailing Address - Street 2:
Mailing Address - City:SUMMERSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42782-0097
Mailing Address - Country:US
Mailing Address - Phone:270-789-9537
Mailing Address - Fax:270-932-9811
Practice Address - Street 1:75 POLICEMAN WAY
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:KY
Practice Address - Zip Code:42743-8397
Practice Address - Country:US
Practice Address - Phone:270-789-9537
Practice Address - Fax:270-932-9811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2179235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty