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Active NPI 1154934172 Individual Practitioner Female Practitioner

Jodie Wallis , CLC, MS, CCC-SLP

Speech-Language Pathologist • Saint Peters, MO

Professional Overview & Biography Verified Profile Summary

Jodie Wallis, CLC, MS, CCC-SLP is a registered healthcare professional specializing in Speech-Language Pathologist in Saint Peters, MO. Practice services are available at 1600 HERITAGE LNDG STE 201 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1600 Heritage Lndg Ste 201

Saint Peters, MO 633038488

Telephone 6367480170
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Saint Peters, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 3.0 Yrs
State Avg: 13.4 Yrs
Regional Practice Density
92 Specialists

Practicing in Saint Peters, MO (5112 Statewide)

Telehealth Adoption Rate
0.0% 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

CMS Verified: 2026-07-21
Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

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.

Lactation Consultant, Non-RN

NUCC Taxonomy Code: 174N00000X

State License None L-322721

An individual trained to provide breastfeeding assistance services to both mothers and infants. Lactation Consultants are not required to be nurses and are trained through specific courses of education. The Lactation Consultant may have additional certification through a national or international organization.

Practice Associates & Co-Workers

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

1 Associated Practitioners
NPI 1154675494

Licensed Professional Counselor

Career & Practice History Timeline

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

17 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 21, 2026

Lactation Consultant, Non-RN (License #L-322721 in None)

📍
Updated Practice Location February 18, 2024

Registered at 1600 HERITAGE LNDG STE 201, SAINT PETERS, MO 633038488 (Tel: 6367480170)

📍
Updated Business Mailing Address February 18, 2024

Registered at 1600 HERITAGE LNDG STE 201, SAINT PETERS, MO 633038488 (Tel: 6367480170)

📍
Updated Practice Location December 12, 2023

Registered at 1404 TRIAD CENTER DR STE A, SAINT PETERS, MO 633767351 (Tel: 6367480170)

📍
Updated Business Mailing Address December 12, 2023

Registered at 1404 TRIAD CENTER DR STE A, SAINT PETERS, MO 633767351 (Tel: 6367480170)

📍
Updated Practice Location March 23, 2023

Registered at 5377 STATE HIGHWAY N, SUITE 456, COTTLEVILLE, MO 63304 (Tel: 8502187484)

📍
Updated Business Mailing Address March 23, 2023

Registered at 5377 STATE HIGHWAY N, SUITE 456, COTTLEVILLE, MO 63304 (Tel: 8502187484)

👤
Provider Name / Credentials Updated March 23, 2023

Recorded as JODIE WALLIS, CLC, MS, CCC-SLP

📍
Updated Practice Location January 12, 2022

Registered at 1400 TRIAD CENTER DR, SAINT PETERS, MO 633767351 (Tel: 3142520153)

📍
Updated Business Mailing Address January 12, 2022

Registered at 1400 TRIAD CENTER DR, SAINT PETERS, MO 633767351 (Tel: 3142520153)

👤
Provider Name / Credentials Updated January 12, 2022

Recorded as JODIE WALLIS, MS, CCC-SLP

NPI Profile Active August 28, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location August 28, 2020

Registered at 567 N AND SOUTH RD APT C, SAINT LOUIS, MO 631303939 (Tel: 3143803088)

📍
Updated Business Mailing Address August 28, 2020

Registered at 567 N AND SOUTH RD APT C, SAINT LOUIS, MO 631303939 (Tel: 3143803088)

👤
Provider Name / Credentials Updated August 28, 2020

Recorded as JODIE WALLIS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 28, 2020

Speech-Language Pathologist

🟢
Initial NPI Registration & Enumeration August 28, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1154934172
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 28, 2020
Last Update: July 21, 2026
Sole Proprietor: No

Mailing Address

1600 Heritage Lndg Ste 201

Saint Peters, MO 633038488

Phone: 6367480170

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.