Melissa Nancy Jensen, M.A., CCC/SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

017973 Issued in NY

Practice address

325 N Kentucky Ave
North Massapequa, NY 11758-1120

Phone

(516) 473-3376

NPI assigned

Mar 7, 2011

Sex

Female

Sole proprietor

No

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

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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

{
    "created_epoch": "1299456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299456000000",
    "number": "1043518681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 N KENTUCKY AVE",
            "city": "NORTH MASSAPEQUA",
            "state": "NY",
            "postal_code": "117581120",
            "telephone_number": "516-473-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N KENTUCKY AVE",
            "city": "NORTH MASSAPEQUA",
            "state": "NY",
            "postal_code": "117581120",
            "telephone_number": "516-473-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "MELISSA",
        "middle_name": "NANCY",
        "credential": "M.A., CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-07",
        "last_updated": "2011-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "017973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dominique Labriola, OTR/L

• Speech-Language Pathologist in North Massapequa, NY
• Providers in North Massapequa, 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 Mar 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.