Individual provider Active NPI

Alexa Terravecchio, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Bordentown, NJ
National Provider Identifier
1457946287
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
41YS01005300 Issued in NJ
Practice address
231 Crosswicks Rd Ste 4
Bordentown, NJ 08505-2602
Phone
(609) 372-4613
NPI assigned
Mar 3, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

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 41YS01005300 NJ Primary

Addresses

Primary practice location

231 Crosswicks Rd Ste 4
Bordentown, NJ 08505-2602

Mailing address

102 Providence Rd Apt 8
Runnemede, NJ 08078-2123

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
41YS01005300NJMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Speech Academy LLC Speech-Language Pathologist PastSince Mar 7, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1457946287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 PROVIDENCE RD APT 8",
            "city": "RUNNEMEDE",
            "state": "NJ",
            "postal_code": "080782123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 CROSSWICKS RD STE 4",
            "city": "BORDENTOWN",
            "state": "NJ",
            "postal_code": "085052602",
            "telephone_number": "609-372-4613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRAVECCHIO",
        "first_name": "ALEXA",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-03",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS01005300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bordentown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; 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.