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Deactivated NPI 1689737421 Deactivated / Inactive NPI Female Practitioner

Jacqulyn Breckow , SLP

Speech-Language Pathologist • Gilbert, AZ

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Jacqulyn Breckow has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 19, 2006
NPI Deactivation Date June 18, 2010
Total Practice Duration ~4 Years of Practice (2006 – 2010)

Professional Overview & Biography Verified Profile Summary

Jacqulyn Breckow, SLP was a registered Speech-Language Pathologist practicing in Gilbert, AZ. Throughout an active medical career spanning 4 years, Jacqulyn Breckow provided care at the practice location at 690 E WARNER RD until profile deactivation on 2010-06-18.

Practice Location & Contact Primary Location

Practice Address

690 E Warner Rd
Suite #105

Gilbert, AZ 852963054

Telephone 4808206366
Fax 4808200462
Associated Practice Facility / Clinic
🏢 Jason C Taylor Dc Llc Facility NPI 1750575205

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Gilbert, AZ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 12.4 Yrs
State Avg: 14.3 Yrs
Regional Practice Density
312 Specialists

Practicing in Gilbert, AZ (4584 Statewide)

Telehealth Adoption Rate
0.3% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License AZ TSLP4726

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
948317 (AZ)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Katherine Tressel , MA CCC SLP

Speech-Language Pathologist

NPI 1033285499

MACCCSLP

Shannon Silvasti , MASTERS COMMUNICATIO

Speech-Language Pathologist

NPI 1053471953

MASTERSCOMMUNICATIO

Robin Myers , MA CCC SLP

Speech-Language Pathologist

NPI 1053479923

MACCCSLP

Lauren Janke

Occupational Therapist

NPI 1053921387
Kylee Castro , MOT, OTR, L

Occupational Therapist - Pediatrics

NPI 1083248439

Master of Occupational Therapy, Occupational Therapist Registered, L

Kaley Schafer

Speech-Language Pathologist

NPI 1093287724

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
📍
Updated Practice Location December 18, 2012

Registered at 690 E WARNER RD, SUITE #105, GILBERT, AZ 852963054 (Tel: 4808206366)

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Updated Business Mailing Address December 18, 2012

Registered at 690 E WARNER RD, SUITE #105, GILBERT, AZ 852963054 (Tel: 4808206366)

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Provider Name / Credentials Updated December 18, 2012

Recorded as JACQULYN BRECKOW, SLP

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Medical Taxonomy / Specialty Registered (Primary Specialty) December 18, 2012

Speech-Language Pathologist (License #TSLP4726 in AZ)

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NPI Profile Reactivated November 02, 2012

Record officially reactivated for active practice on November 02, 2012

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NPI Profile Deactivated June 18, 2010

Record deactivated on June 18, 2010

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Initial NPI Registration & Enumeration December 19, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1689737421
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 19, 2006
Last Update: December 18, 2012
Deactivation Date: June 18, 2010
Sole Proprietor: Yes

Mailing Address

690 E Warner Rd, Suite #105

Gilbert, AZ 852963054

Phone: 4808206366

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.