Active NPI
Krishona Weller, M.A., CCC-SLP, TSSLD
- Speech-Language Pathologist
- Palisades, NY
National Provider Identifier
1417205238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 022798-1
- Practice address
- 680 Oak Tree Rd
Palisades, NY 10964-1532 - Phone
- (845) 359-8846
- NPI assigned
- Aug 28, 2012
- Last updated
- Feb 6, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 022798-1 | NY | Primary |
Addresses
Primary practice location
680 Oak Tree Rd
Palisades, NY 10964-1532
Mailing address
256 Mount Pleasant Rd
Hauppauge, NY 11788-2746
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03654455 | Medicaid | NY |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 022798-1 | NY | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391644800000",
"number": "1417205238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "256 MOUNT PLEASANT RD",
"city": "HAUPPAUGE",
"state": "NY",
"postal_code": "117882746"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "680 OAK TREE RD",
"city": "PALISADES",
"state": "NY",
"postal_code": "109641532",
"telephone_number": "845-359-8846"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLER",
"first_name": "KRISHONA",
"credential": "M.A., CCC-SLP, TSSLD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-28",
"last_updated": "2014-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "022798-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03654455",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palisades, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.