Kira Enid Medina-Tiencken, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

41YS00796200 Issued in NJ

Practice address

31 Chestnut Ter
Bloomfield, NJ 07003-4408

Phone

(862) 812-1552

NPI assigned

May 30, 2018

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)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Super Kids Speech Therapy and Educational Services

  • Speech-Language Pathologist
  • Bloomfield, NJ
  • NPI 1932926268
  NPD Authorized official
• Expressable Therapy of New Jersey PC

  • Speech-Language Pathologist
  • Roseland, NJ
  • NPI 1811615685
  NPD
• Expressable Speech-Language Pathology, P.C.

  • Speech-Language Pathologist
  • Austin, TX
  • NPI 1649875857
  NPD

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

{
    "created_epoch": "1527638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527638400000",
    "number": "1336631902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 CHESTNUT TER",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070034408",
            "telephone_number": "862-812-1552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 CHESTNUT TER",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070034408",
            "telephone_number": "862-812-1552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA-TIENCKEN",
        "first_name": "KIRA",
        "middle_name": "ENID",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-30",
        "last_updated": "2018-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00796200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn McLaughlin, IBCLC
• Carli Rae McMorrow, ATC
• Deanna McPherson, MPH, MSW, LCSW
• Med-Stat Healthcare Inc
• Medexpress Urgent Care - Northern New Jersey, PC
• Brooks Kenneth Meek, LCSW
• Ruchi Mehta, M.D.
• Daniel E Melon, PT, DPT
• Alexis Melvin
• Clara Waya Memba

• Speech-Language Pathologist in Bloomfield, NJ
• Providers in Bloomfield, NJ by specialty
• Speech-Language Pathologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2018; 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.