Individual provider Active NPI

Alethea St.Bernard Marshall, MSED TSHH

  • Speech-Language Pathologist
  • Brooklyn, NY
National Provider Identifier
1073945481
Registry record updated Aug 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4154 Issued in NY
Practice address
984 E 94TH St
Brooklyn, NY 11236-2024
Phone
(646) 261-3418
NPI assigned
Aug 7, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2013

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 4154 NY Primary

Addresses

Primary practice location

984 E 94TH St
Brooklyn, NY 11236-2024

Mailing address

984 E 94TH St
Brooklyn, NY 11236-2024
Phone (646) 261-3418

Other identifiers 1

IdentifierTypeStateIssuer
4154OtherNYEARLY INTERVENTION STATE ID#4154

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

State licenses

LicenseStateTypeSpecialty
4154NYMDNutrition Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
St.Bernard Marshall Special Services Corp PastSince Dec 22, 2019 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1375833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375833600000",
    "number": "1073945481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "984 E 94TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112362024",
            "telephone_number": "646-261-3418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "984 E 94TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112362024",
            "telephone_number": "646-261-3418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "ALETHEA",
        "middle_name": "ST.BERNARD",
        "credential": "MSED TSHH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-07",
        "last_updated": "2013-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "4154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EARLY INTERVENTION STATE ID#4154",
            "identifier": "4154",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2013; 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.