Jacqueline Alexis Alvarado

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

30003455 Issued in NC

Practice address

6144 Route 25a Ste 9B
Wading River, NY 11792-2015

Phone

(631) 325-7755

Fax

(631) 886-1419

NPI assigned

Oct 3, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Manorville Speech Pathology, PC

  • Early Intervention Provider Agency
  • Wading River, NY
  • NPI 1942443213
  NPD (past)
• Child and Family Development Inc.

  • Physical Therapist
  • Charlotte, NC
  • NPI 1437125085

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1346725546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 KINGSLAND AVE",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119671525",
            "telephone_number": "631-902-8826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6144 ROUTE 25A STE 9B",
            "city": "WADING RIVER",
            "state": "NY",
            "postal_code": "117922015",
            "telephone_number": "631-325-7755",
            "fax_number": "631-886-1419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALVARADO",
        "first_name": "JACQUELINE",
        "middle_name": "ALEXIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-03",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "30003455",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "029690",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arielle Jena Abbato, OT
• Jolene Rene Abran, LMSW
• Valerie J Aiosa-Frost, LCSW
• Alexis Hugelmeyer, D.O.
• Sofia Z. Almiroudis, SLP, TSHH, MSED
• Marret Anderson, NP-C
• Danielle Lynn Bacile
• Daniel Bauman, P.T.
• Clifford Baynon, DDS
• Guy-Philippe Beauzile

• All providers in Wading River, 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 9, 2024; 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.