Kellene McCall Coulombe, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

41YS00729200 Issued in NJ

Practice address

102 Independence Dr
Woodbury, NJ 08096-6874

Phone

(856) 469-7187

NPI assigned

Mar 11, 2014

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)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bayada Home Health Care, Inc.

  • Home Health Agency
  • Moorestown, NJ
  • NPI 1366716565
  NPD (past)

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

{
    "created_epoch": "1394496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466467200000",
    "number": "1154747434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 INDEPENDENCE DR",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080966874",
            "telephone_number": "856-469-7187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 INDEPENDENCE DR",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080966874",
            "telephone_number": "856-469-7187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULOMBE",
        "first_name": "KELLENE",
        "middle_name": "MCCALL",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-11",
        "last_updated": "2016-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00729200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cooper Family Medicine PC
• Norman S Cormier
• Corsi Dental Associates
• Christine Nicole Cosico, PHARMD
• Regina M Costroff, PA-C
• John Covotta IV, PHARMD
• Craig H Rosen MD PA
• Judith Craig, RPH
• Ginean Crawford, MFT, LPC
• Robert Crawford, EDD, MS, LPC

• All providers in Woodbury, NJ
• Speech-Language Pathologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2016; 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.