Individual provider Active NPI

Beth F Mormando, MA CCCSLP

  • Speech-Language Pathologist
  • Ballston Spa, NY
National Provider Identifier
1497837082
Registry record updated Jul 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
0157611 Issued in NY
Practice address
16 Saratoga Bridges Blvd
Saratoga Bridges
Ballston Spa, NY 12020
Phone
(518) 587-0723
Fax
(518) 583-9607
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2009

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 0157611 NY Primary

Addresses

Primary practice location

16 Saratoga Bridges Blvd
Saratoga Bridges
Ballston Spa, NY 12020

Mailing address

16 Saratoga Bridges Blvd
Ballston Spa, NY 12020
Phone (518) 587-5747

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

LicenseStateTypeSpecialty
0157611NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247788800000",
    "number": "1497837082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 SARATOGA BRIDGES BLVD",
            "city": "BALLSTON SPA",
            "state": "NY",
            "postal_code": "12020",
            "telephone_number": "518-587-5747",
            "fax_number": "518-583-9607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 SARATOGA BRIDGES BLVD",
            "address_2": "SARATOGA BRIDGES",
            "city": "BALLSTON SPA",
            "state": "NY",
            "postal_code": "12020",
            "telephone_number": "518-587-0723",
            "fax_number": "518-583-9607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORMANDO",
        "first_name": "BETH",
        "middle_name": "F",
        "credential": "MA CCCSLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2009-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "0157611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballston Spa, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2009; 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.