Individual provider Active NPI

Susan L Young, MS,CCC/SLP

  • Speech-Language Pathologist
  • Staten Island, NY
National Provider Identifier
1194961987
Registry record updated Dec 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
004856 Issued in NY
Practice address
250 Barclay Ave
Staten Island, NY 10312-4802
Phone
(718) 984-1198
NPI assigned
Dec 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 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 004856 NY Primary

Addresses

Primary practice location

250 Barclay Ave
Staten Island, NY 10312-4802

Mailing address

250 Barclay Ave
Staten Island, NY 10312-4802
Phone (718) 984-1198

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

NPI Registry JSON

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

{
    "created_epoch": "1230422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230422400000",
    "number": "1194961987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 BARCLAY AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103124802",
            "telephone_number": "718-984-1198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 BARCLAY AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103124802",
            "telephone_number": "718-984-1198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "SUSAN",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "MS,CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-28",
        "last_updated": "2008-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "004856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.