Individual provider Active NPI

Kelly Maria Conlin, M.S. CCC SLP

  • Speech-Language Pathologist
  • White Plains, NY
National Provider Identifier
1124415906
Registry record updated Apr 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
024293 Issued in NY
Practice address
47 Davis Ave
Apt. 2B
White Plains, NY 10605-1031
Phone
(516) 660-9980
NPI assigned
Apr 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2015

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 024293 NY Primary

Addresses

Primary practice location

47 Davis Ave
Apt. 2B
White Plains, NY 10605-1031

Mailing address

47 Davis Ave
Apt. 2B
White Plains, NY 10605-1031
Phone (516) 660-9980

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

LicenseStateTypeSpecialty
024293NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1429488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429488000000",
    "number": "1124415906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 DAVIS AVE",
            "address_2": "APT. 2B",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106051031",
            "telephone_number": "516-660-9980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 DAVIS AVE",
            "address_2": "APT. 2B",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106051031",
            "telephone_number": "516-660-9980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONLIN",
        "first_name": "KELLY",
        "middle_name": "MARIA",
        "credential": "M.S. CCC SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-20",
        "last_updated": "2015-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "024293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; 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.