Kelli Lynn McKenna-D'Ambrosio, M.A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

013780-1 Issued in NY

Practice address

161 Clinton St
Avon, NY 14414-1432

Phone

(585) 226-2455

NPI assigned

Dec 7, 2011

Sex

Female

Sole proprietor

No

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)

Not enrolled

Credentials

Master of Arts

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.

• Livingston County

  • Community Based Hospice Care Agency
  • Mount Morris, NY
  • NPI 1326060724
  NPD (past)

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

{
    "created_epoch": "1323216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1285902007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4972 LAKE RD",
            "city": "AVON",
            "state": "NY",
            "postal_code": "144149797",
            "telephone_number": "585-226-9172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 CLINTON ST",
            "city": "AVON",
            "state": "NY",
            "postal_code": "144141432",
            "telephone_number": "585-226-2455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENNA-D'AMBROSIO",
        "first_name": "KELLI",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-07",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "013780-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lattimore of Geneseo Physical Therapy PC
• Donyelle M Losee, DPT
• Andrea Rose Maggioli, PHARM D
• Wesley Herrick Marean III
• Caitlin McCauley, ATC
• Nicole P Montesano, R.N.
• Lynn Marie Northup, PT
• Michael Kevin Oros, DDS
• Dorene Palmer
• Diana Marie Ray, LMHC-D

• All providers in Avon, NY
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; 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.