Individual provider Active NPI

Brooke Hagedoorn, CCC-SLP

  • Speech-Language Pathologist
  • Wyckoff, NJ
National Provider Identifier
1205798428
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
41YS00828800 Issued in NJ
Practice address
8 Van Blarcom LN
Wyckoff, NJ 07481-3444
Phone
(973) 897-9948
NPI assigned
Nov 25, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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 41YS00828800 NJ Primary

Addresses

Primary practice location

8 Van Blarcom LN
Wyckoff, NJ 07481-3444

Mailing address

8 Van Blarcom LN
Wyckoff, NJ 07481-3444
Phone (973) 897-9948

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

State licenses

LicenseStateTypeSpecialty
41YS00828800NJMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1764028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1205798428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 VAN BLARCOM LN",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074813444",
            "telephone_number": "973-897-9948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 VAN BLARCOM LN",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074813444",
            "telephone_number": "973-897-9948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEDOORN",
        "first_name": "BROOKE",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-11-25",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00828800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyckoff, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2025; 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.