Provider Demographics
NPI:1780317354
Name:CAVALIERI, MADISON KAE (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MADISON
Middle Name:KAE
Last Name:CAVALIERI
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MS
Other - First Name:MADISON
Other - Middle Name:KAE
Other - Last Name:WEINBERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:10909 MILL VALLEY RD
Mailing Address - Street 2:UNIT 210
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154
Mailing Address - Country:US
Mailing Address - Phone:402-391-5002
Mailing Address - Fax:308-210-4215
Practice Address - Street 1:10909 MILL VALLEY RD
Practice Address - Street 2:UNIT 210
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154
Practice Address - Country:US
Practice Address - Phone:402-391-5002
Practice Address - Fax:402-343-1278
Is Sole Proprietor?:No
Enumeration Date:2022-07-01
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2806235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE903OtherTEMPORARY SLP LICENSE
NE903Medicaid