Nicole M Lewis, M.S., CCC-SLP, TSSLD

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

030687 Issued in NY

Practice address

115 Emmet Ave
Staten Island, NY 10306-3851

Phone

(917) 718-3083

NPI assigned

Jul 14, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1013525229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 EMMET AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103063851",
            "telephone_number": "718-300-0655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 EMMET AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103063851",
            "telephone_number": "917-718-3083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "NICOLE",
        "middle_name": "M",
        "credential": "M.S., CCC-SLP, TSSLD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-14",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "030687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Estelle Lewis, LCSW-R
• Glenda Lewis, RN
• Jasmine Lewis
• Kecia Leann Lewis, LCSW
• Kimberley Ann Lewis, LCSW-R
• Zachary M Lewter, CRNA
• Lona Leybengrub, RD
• Ira Leykin
• Lina Leykina, M.D.
• Sofya Leykina, PT

• Speech-Language Pathologist in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.