IndividualActive
Mary Petersen, M.A. CCC-SLP
NPI 1114938016 · Speech-Language Pathologist · Cleveland, OH
Provider details
- NPI number
- 1114938016
- Entity type
- Individual
- Primary specialty
- Speech-Language PathologistSpeech, Language and Hearing Service Providers
- Credential
- M.A. CCC-SLP
- Sex
- Female
- Sole proprietor
- No
- License
- SP.8246 (OH)
Specialties & taxonomies
Speech, Language and Hearing Service Providers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
10701 East Blvd
Audiology and Speech Pathology 126 W
Cleveland, OH 44106-1702
Phone: (216) 791-3800
Fax: (216) 707-5958
Street-level locationGet directions
Mailing address
3925 W 210th St
Fairview Park, OH 44126-1404
Registry dates
- Enumerated
- 2006-08-10
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.