Kimberly Ann Portello, MA CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

41YS00334000 Issued in NJ

Practice address

30 Mead Ave
Freehold, NJ 07728-1817

Phone

(732) 580-6947

NPI assigned

Mar 14, 2026

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1773446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773446400000",
    "number": "1134076490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 MEAD AVE",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077281817",
            "telephone_number": "732-580-6947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MEAD AVE",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077281817",
            "telephone_number": "732-580-6947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTELLO",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-14",
        "last_updated": "2026-03-14",
        "certification_date": "2026-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00334000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Freehold, NJ
• Providers in Freehold, NJ by specialty
• Speech-Language Pathologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2026; 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.