Keely Anne Lavelle, M.A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

023053 Issued in NY

Practice address

285 Edison St
Staten Island, NY 10306-3156

Phone

(718) 619-6093

NPI assigned

Mar 3, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2012

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Master of Science

State licenses

Practice roles

Locations

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.

• Barnabas Health Medical Group, PC

  • Specialist
  • West Orange, NJ
  • NPI 1447206420
  Medicare reassignment NPD

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

{
    "created_epoch": "1425340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425340800000",
    "number": "1164814943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 EDISON ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103063156",
            "telephone_number": "718-619-6093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 EDISON ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103063156",
            "telephone_number": "718-619-6093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVELLE",
        "first_name": "KEELY",
        "middle_name": "ANNE",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-03",
        "last_updated": "2015-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "023053",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00732200",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Ann Lauro, LMFT
• David Norman Lavallee Jr., PA-C
• Julie Lavalliere, DO
• Jatu Yamaloupo Lavelah, GNP
• Kathleen Ann Lavelle, RN,BC
• Kristin Lavelle, M.S., CCC-SLP
• Teresa Laverie, PTA
• Melanie Cantos Lavides
• John A Lavinio, DDS
• Lai M Law, OTR/L

• Speech-Language Pathologist in Staten Island, NY
• Providers in Staten Island, 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 Mar 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.