Individual provider Active NPI

Stacey Beth Sinclair, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Skaneateles, NY
National Provider Identifier
1174775175
Registry record updated Oct 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
12115889 Issued in NY
Practice address
22 E Lake St
Skaneateles, NY 13152-1305
Phone
(315) 685-7928
Fax
(315) 218-7644
NPI assigned
Oct 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2008

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 12115889 NY Primary

Addresses

Primary practice location

22 E Lake St
Skaneateles, NY 13152-1305

Mailing address

3 Little Fox Cir
Fayetteville, NY 13066-1722
Phone (315) 446-5651

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
12115889NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Partners in OT,PT and Speech Language Pathology PLLC Past Accepting new patients
Therapy Partners in OT, PT, and Speech-Language Pathology, PLLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224547200000",
    "number": "1174775175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 LITTLE FOX CIR",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661722",
            "telephone_number": "315-446-5651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 E LAKE ST",
            "city": "SKANEATELES",
            "state": "NY",
            "postal_code": "131521305",
            "telephone_number": "315-685-7928",
            "fax_number": "315-218-7644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SINCLAIR",
        "first_name": "STACEY",
        "middle_name": "BETH",
        "name_prefix": "Ms.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-21",
        "last_updated": "2008-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "12115889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skaneateles, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2008; 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.