Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1063661916 Individual Practitioner Female Practitioner

Mary Alice Petersen , MA, CCC-SLP

Speech-Language Pathologist • Newcastle, WY

Professional Overview & Biography Verified Profile Summary

Mary Petersen, MA, CCC-SLP is a registered healthcare professional specializing in Speech-Language Pathologist in Newcastle, WY. Practice services are available at 104 STAMPEDE ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

104 Stampede St

Newcastle, WY 827013037

Telephone 3077464560
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Newcastle, WY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 14.7 Yrs
Regional Practice Density
4 Specialists

Practicing in Newcastle, WY (331 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

Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License WY #SP-391

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.

Practice Associates & Co-Workers

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

4 Associated Practitioners
Michalyn Trimble

Occupational Therapist

NPI 1003578220
Nathina Crabtree

Occupational Therapist

NPI 1053984120
Nicole Jordan , SLP

Speech-Language Pathologist

NPI 1215288162

Speech-Language Pathologist

NPI 1730339151

Occupational Therapist Registered, L

Career & Practice History Timeline

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

11 Historical Events
NPI Profile Active February 15, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location February 15, 2017

Registered at 104 STAMPEDE ST, NEWCASTLE, WY 827013037 (Tel: 3077464560)

📍
Updated Business Mailing Address February 15, 2017

Registered at 104 STAMPEDE ST, NEWCASTLE, WY 827013037 (Tel: 3077464560)

👤
Provider Name / Credentials Updated February 15, 2017

Recorded as MARY PETERSEN, MA, CCC-SLP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 15, 2017

Speech-Language Pathologist (License ##SP-391 in WY)

NPI Profile Active September 16, 2008

NPI status registered as active in NPPES database

📍
Updated Practice Location September 16, 2008

Registered at 104 STAMPEDE ST, NEWCASTLE, WY 827013037 (Tel: 3077464560)

📍
Updated Business Mailing Address September 16, 2008

Registered at 104 STAMPEDE ST, NEWCASTLE, WY 827013037 (Tel: 3077464560)

👤
Provider Name / Credentials Updated September 16, 2008

Recorded as MARY PETERSEN, MA, CCC-SLP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 16, 2008

Speech-Language Pathologist (License ##SP-391 in WY)

🟢
Initial NPI Registration & Enumeration September 16, 2008

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: 1063661916
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 16, 2008
Last Update: February 15, 2017
Sole Proprietor: Yes

Mailing Address

104 Stampede St

Newcastle, WY 827013037

Phone: 3077464560

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.