Individual provider Active NPI

Jillian Elissabeth Bobal, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Clinton, NJ
National Provider Identifier
1043085525
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
41YS00878600 Issued in NJ
Practice address
26 Lingert Ave
Clinton, NJ 08809-1219
Phone
(908) 208-5908
NPI assigned
Nov 15, 2023
Last updated
Nov 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 41YS00878600 NJ Primary

Addresses

Primary practice location

26 Lingert Ave
Clinton, NJ 08809-1219

Mailing address

26 Lingert Ave
Clinton, NJ 08809-1219
Phone (908) 208-5908

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
41YS00878600NJMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1700006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1043085525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 LINGERT AVE",
            "city": "CLINTON",
            "state": "NJ",
            "postal_code": "088091219",
            "telephone_number": "908-208-5908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 LINGERT AVE",
            "city": "CLINTON",
            "state": "NJ",
            "postal_code": "088091219",
            "telephone_number": "908-208-5908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBAL",
        "first_name": "JILLIAN",
        "middle_name": "ELISSABETH",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-15",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00878600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; 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.