DR. MARY T CACCAVO


Address: 2122 Scott St., Lafayette, IN 47904-2932
Phone: 7654486226

DR. MARY T CACCAVO (NPI# 1134116031) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1134116031
Entity Type Individual
Full Name DR. MARY T CACCAVO
Credential PH.D.
Practice Address 2122 Scott St.
Lafayette
IN 47904-2932
Mailing Address 2122 Scott St.
Lafayette
IN 47904
Practice Telephone 7654486226
Practice Fax Number 7654489416
Mailing Telephone 7654486226
Mailing Fax Number 7654489416
Enumeration Date 2005-10-05
Last Update Date 2010-06-28
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 231H00000X Audiologist 23001132A IN Speech, Language and Hearing Service Providers
N 237600000X Audiologist-Hearing Aid Fitter 23001132A IN Speech, Language and Hearing Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
IN BCBS UAW 000000220882 01
IN BLUE CROSS BLUE SHIELD 000000220890 01
IN FEDERAL BCBS 000000220890 01
IN 100232400A 05
IN RAILROAD MEDICARE 640004350 01
IN BCBS UAW 000000202141 01

Office Location

Street Address 2122 SCOTT ST.
City LAFAYETTE
State IN
Zip Code 47904-2932

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1568998615 Angela Hands Physical Therapy Assistant 1260 North 17th Street, Lafayette, IN 47904 2017-05-11
1366894164 Kathryn Barnett Behavioral Analyst 2785 Cason St # 2, Lafayette, IN 47904 2016-07-06
1881972917 Rest Assured, LLC Durable Medical Equipment & Medical Supplies 180 Professional Ct., Lafayette, IN 47904 2011-07-22
1144514233 Michelle Cristin Singleton Dietitian, Registered 508 N 26th St, Lafayette, IN 47904 2011-06-06
1912134438 Jean D Trammel Marriage & Family Therapist 2000 Greenburg St, Bldg B, Suite A, Lafayette, IN 47904 2009-06-11
1902946056 Terry Richard Baker Optometrist 2300 Sagamore Parkway S, Lafayette, IN 47904 2007-02-07
1891862165 Becki A Bowditch Inc Social Worker 2201 Ferry Street, Lafayette, IN 47904 2006-11-29
1326121849 James Lowell Thomas Pediatrics 2300 Ferry St, Lafayette, IN 47904 2006-10-21
1700976719 Michael Leonard Bagnoli Dentist 2020 Union Street, Suite 200, Lafayette, IN 47904 2006-10-13
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Taxonomy Information

Taxonomy Code 231H00000X
Grouping Speech, Language and Hearing Service Providers
Classification Audiologist

Taxonomy Definition

(1) A specialist in evaluation, habilitation and rehabilitation of those whose communication disorders center in whole or in part in hearing function. Audiologists are autonomous professionals who identify, assess, and manage disorders of the auditory, balance and other neural systems. Audiologists provide audiological (aural) rehabilitation to children and adults across the entire age span. Audiologists select, fit and dispense amplification systems such as hearing aids and related devices. (2) An audiologist is a person qualified by a master’s degree in audiology, licensed by the state, where applicable, and practicing within the scope of that license. Audiologists evaluate and treat patients with impaired hearing. They plan, direct and conduct rehabilitative programs with audiotry substitutional devises (hearing aids) and other therapy.
Notes: Source: (1) American Speech-Language-Hearing Association, (1996, Spring) Scope of practice in Audiology, p. 2

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1154842300 Calli Cabrini Dugas Audiologist 4630 Ambassador Caffery Pkwy Ste 402, Lafayette, LA 70508-6950 2017-06-28
1609268895 Martin John Audiffred Audiologist 249 N College Rd, Lafayette, LA 70506-4230 2015-02-24
1235425000 Maegan Guilbeau Audiologist 220 W Willow St, Bldg. A, Lafayette, LA 70501-2837 2011-06-21
1417279472 Mtc of Indiana, Ltd. Audiologist 823 Park East Blvd, Lafayette, IN 47905-0787 2010-02-18
1952567273 Amy Davis Poolson Audiologist 4630 Ambassador Caffery Parkway, Bldg., A, Suite 402, Lafayette, LA 70508-6949 2008-08-06
1679745301 Valarie Kay Darr Audiologist 5000 Ambassador Caffrey Pkwy, Building 3, Lafayette, LA 70508 2008-04-02
1932377264 Naomi Pontiff Theriot Audiologist 110 Exchange Place, Suite 100, Lafayette, LA 70503-2580 2008-02-20
1447432802 Susan M. Taulia Audiologist 823 Park East Blvd # H, Lafayette, IN 47905-0787 2007-11-28
1255511929 Audiology Associates of Acadiana Audiologist 110 Exchange Pl, Suite 100, Lafayette, LA 70503-2510 2007-11-09
1265574404 Judith Marquess Olson Audiologist 750 Park East Blvd Ste 3, Lafayette, IN 47905 2007-02-13
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City LAFAYETTE
Zip Code 47904

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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