Blake Woodworth, MA; CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

015097-1 Issued in NY

Practice address

161 East Main Street
O'Brien Speech, Language and Learning PLLC
Huntington, NY 11743

Phone

(631) 423-7700

NPI assigned

Nov 5, 2009

Last updated

Nov 5, 2009By the provider in NPPES

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

State licenses

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

{
    "created_epoch": "1257379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257379200000",
    "number": "1144557562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 FORT HILL ROAD",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "11743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 EAST MAIN STREET",
            "address_2": "O'BRIEN SPEECH, LANGUAGE AND LEARNING PLLC",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "11743",
            "telephone_number": "631-423-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODWORTH",
        "first_name": "BLAKE",
        "credential": "MA; CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-05",
        "last_updated": "2009-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "015097-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan J Wolff
• Lance Ian Wolfson, MHC
• Emily Wolstedlund
• Ronald Wood
• Eloise Woodward
• Kerriann Worth, L.M.T.
• Adam Francis Wos, MD
• Haley Nicole Wyckoff, REGISTERED NURSE
• Samuel Xu
• Dawn H Yablonski, P.T.

• Speech-Language Pathologist in Huntington, NY
• Providers in Huntington, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2009; 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.