Johanna Smialek, M.A., CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Greenwich, NY
NPI 1295987394 · NPPES record last updated Sep 3, 2014
Key facts
- NPI
- 1295987394
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 010904 (NY)
- Practice address
- 14 Corliss Ave
Greenwich, NY 12834-1004 - Phone
- (518) 692-7153
- NPI assigned
- Oct 21, 2008
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 010904 | NY | Yes |
Addresses
Primary practice location
14 Corliss Ave
Greenwich, NY 12834-1004
Mailing address
14 Corliss Ave
Greenwich, NY 12834-1004
Phone (518) 692-7153
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03642239 | Medicaid | NY |
Other providers in Greenwich, NY
- Donna Lynn Schaper
- Molly Schoder
- Paul Robert Seegers
- Jennifer J Sharp
- Stephannie Anne Siwik-Simpson
- Joanne P Steele
- Robert Stein
- Jonathan Torres
- Jessica Rae Townsend
- Kristine R. Ulrich
All providers in Greenwich, NY · Speech-Language Pathologist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.