Active NPI
Johanna C Chacon, M.A., CCC-SLP
- Speech-Language Pathologist
- Cranford, NJ
National Provider Identifier
1114487725
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 41YS00881200
- Practice address
- 10 Alden St
Cranford, NJ 07016-2176 - Phone
- (908) 272-3400
- NPI assigned
- Mar 20, 2019
- 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 | 41YS00881200 | NJ | Primary |
Addresses
Primary practice location
10 Alden St
Cranford, NJ 07016-2176
Mailing address
54 Stacy CT
Old Bridge, NJ 08857-2673
Phone (732) 882-5519
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
| License | State | Type | Specialty |
|---|---|---|---|
| 41YS00881200 | NJ | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553040000000",
"number": "1114487725",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "54 STACY CT",
"city": "OLD BRIDGE",
"state": "NJ",
"postal_code": "088572673",
"telephone_number": "732-882-5519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 ALDEN ST",
"city": "CRANFORD",
"state": "NJ",
"postal_code": "070162176",
"telephone_number": "908-272-3400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHACON",
"first_name": "JOHANNA",
"middle_name": "C",
"credential": "M.A., CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-20",
"last_updated": "2019-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NJ",
"license": "41YS00881200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cranford, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.