Individual provider Active NPI

Richelle Beverly Mitchell, M.S. SLP

  • Speech-Language Pathologist
  • Latham, NY
National Provider Identifier
1427310705
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
022401-1 Issued in NY
Practice address
60 Latham Ridge Rd
Latham, NY 12110-3032
Phone
(585) 469-9503
NPI assigned
Jun 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 022401-1 NY Primary

Addresses

Primary practice location

60 Latham Ridge Rd
Latham, NY 12110-3032

Mailing address

60 Latham Ridge Rd
Latham, NY 12110-3032
Phone (585) 469-9503

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 Science

State licenses

LicenseStateTypeSpecialty
022401-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355270400000",
    "number": "1427310705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 LATHAM RIDGE RD",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121103032",
            "telephone_number": "585-469-9503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 LATHAM RIDGE RD",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121103032",
            "telephone_number": "585-469-9503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "RICHELLE",
        "middle_name": "BEVERLY",
        "name_prefix": "Ms.",
        "credential": "M.S. SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-12",
        "last_updated": "2012-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "022401-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2012; 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.