Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1013002971 Individual Practitioner Female Practitioner

Susan Koller , MA, CCC-SLP

Speech-Language Pathologist • Albuquerque, NM

Professional Overview & Biography Verified Profile Summary

Susan Koller, MA, CCC-SLP is a registered healthcare professional specializing in Speech-Language Pathologist in Albuquerque, NM. Practice services are available at 2819 RICHMOND DR NE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2819 Richmond Dr Ne

Albuquerque, NM 871071918

Telephone 5058833787
Fax 5058300106
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Albuquerque, NM

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 16.8 Yrs
State Avg: 20.3 Yrs
Regional Practice Density
887 Specialists

Practicing in Albuquerque, NM (2057 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: 2020-09-10
Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License NM 662

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
65824563 (NM)
Commercial Insurance / Payer ID Lovelace Health Plan
10026768 (NM)
Commercial Insurance / Payer ID Molina Health Care
QMYPR0072408 (NM)

Practice Associates & Co-Workers

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

11 Associated Practitioners
Michael Trout , MS, CCC-SLP

Speech-Language Pathologist

NPI 1053406975

Master of Science, Speech-Language Pathologist (Certificate of Clinical Competence)

Jisun Lee , MS, SLP

Speech-Language Pathologist

NPI 1124783089

Master of Science, Speech-Language Pathologist

Karin Tydeman , SLP

Speech-Language Pathologist

NPI 1265779573

Speech-Language Pathologist

Virginia Matsko , MS, CCC-SLP

Speech-Language Pathologist

NPI 1396830279

Master of Science, Speech-Language Pathologist (Certificate of Clinical Competence)

Christina Brown , MA, CCC-SLP

Speech-Language Pathologist

NPI 1487749479

Master of Arts, Speech-Language Pathologist (Certificate of Clinical Competence)

Sarah Cocciardi , SLP

Speech-Language Pathologist

NPI 1508424094

Speech-Language Pathologist

Career & Practice History Timeline

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

8 Historical Events
📍
Updated Business Mailing Address September 10, 2020

Registered at 3301 MONROE ST NE UNIT I98, ALBUQUERQUE, NM 871101873 (Tel: 5059804563)

👤
Provider Name / Credentials Updated September 10, 2020

Recorded as SUSAN KOLLER, M.A., CCC-SLP

NPI Profile Active July 09, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 09, 2007

Registered at 2819 RICHMOND DR NE, ALBUQUERQUE, NM 871071918 (Tel: 5058833787)

📍
Updated Business Mailing Address July 09, 2007

Registered at PO BOX 1255, TIJERAS, NM 870591255 (Tel: 5059804563)

👤
Provider Name / Credentials Updated July 09, 2007

Recorded as SUSAN KOCIPAK, M.A., CCC-SLP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 09, 2007

Speech-Language Pathologist (License #662 in NM)

🟢
Initial NPI Registration & Enumeration October 04, 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: 1013002971
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 04, 2006
Last Update: September 10, 2020
Sole Proprietor: No

Mailing Address

3301 Monroe St Ne Unit I98

Albuquerque, NM 871101873

Phone: 5059804563

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.