Active NPI
Ilyce S Brinn, M.S. CCC-SLP
- Speech-Language Pathologist
- Liberty, NY
National Provider Identifier
1124399209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 013178-1
- Practice address
- 25 Brookview Dr
Liberty, NY 12754-2601 - Phone
- (914) 799-0695
- NPI assigned
- Jan 20, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 | 013178-1 | NY | Primary |
Addresses
Primary practice location
25 Brookview Dr
Liberty, NY 12754-2601
Mailing address
PO Box 481
Rock Hill, NY 12775-0481
Phone (914) 799-0695
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 |
|---|---|---|---|
| 013178-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327017600000",
"number": "1124399209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 481",
"city": "ROCK HILL",
"state": "NY",
"postal_code": "127750481",
"telephone_number": "914-799-0695"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 BROOKVIEW DR",
"city": "LIBERTY",
"state": "NY",
"postal_code": "127542601",
"telephone_number": "914-799-0695"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRINN",
"first_name": "ILYCE",
"middle_name": "S",
"name_prefix": "Ms.",
"credential": "M.S. CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-01-20",
"last_updated": "2012-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "013178-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Liberty, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.