Active NPI
Jacqueline Deanne Havranek, MS, CCC, SLP ,TSHH
- Speech-Language Pathologist
- Bronx, NY
National Provider Identifier
1043425929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 016617
- Practice address
- 2826 Westchester Ave
Bronx, NY 10461-4514 - Phone
- (718) 554-2025
- NPI assigned
- May 13, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 016617 | NY | Primary |
Addresses
Primary practice location
2826 Westchester Ave
Bronx, NY 10461-4514
Mailing address
41 Parsons St
Harrison, NY 10528-3711
Phone (845) 304-5140
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016617 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595548800000",
"number": "1043425929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41 PARSONS ST",
"city": "HARRISON",
"state": "NY",
"postal_code": "105283711",
"telephone_number": "845-304-5140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2826 WESTCHESTER AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104614514",
"telephone_number": "718-554-2025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAVRANEK",
"first_name": "JACQUELINE",
"middle_name": "DEANNE",
"name_prefix": "Ms.",
"credential": "MS, CCC, SLP ,TSHH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-13",
"last_updated": "2020-07-24",
"certification_date": "2020-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "016617",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.