Individual provider Active NPI

Sylvia Rose Mattice, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Tupper Lake, NY
National Provider Identifier
1083104632
Registry record updated Aug 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
027646 Issued in NY
Practice address
L.P. Quinn Elementary
294 Hosley Ave
Tupper Lake, NY 12986-1555
Phone
(518) 359-2981
NPI assigned
May 18, 2018
Last updated
Aug 24, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2018

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 027646 NY Primary

Addresses

Primary practice location

L.P. Quinn Elementary
294 Hosley Ave
Tupper Lake, NY 12986-1555

Mailing address

L.P. Quinn Elementary
294 Hosley Ave
Tupper Lake, NY 12986-1555
Phone (518) 359-2981

Other practice location 1

205 State Street Rd
Canton, NY 13617-3302
Phone (315) 386-4541 ext. 3341

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
027646NYMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1526601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535068800000",
    "number": "1083104632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "L.P. QUINN ELEMENTARY",
            "address_2": "294 HOSLEY AVE",
            "city": "TUPPER LAKE",
            "state": "NY",
            "postal_code": "129861555",
            "telephone_number": "518-359-2981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "L.P. QUINN ELEMENTARY",
            "address_2": "294 HOSLEY AVE",
            "city": "TUPPER LAKE",
            "state": "NY",
            "postal_code": "129861555",
            "telephone_number": "518-359-2981"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 State Street Rd",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "NY",
            "postal_code": "136173302",
            "country_code": "US",
            "telephone_number": "315-386-4541 x3341",
            "fax_number": "315-229-4872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTICE",
        "first_name": "SYLVIA",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-18",
        "last_updated": "2018-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "027646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupper Lake, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2018; 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.