Active NPI
Adirondack Enrichment, a Speech Pathology Occupational Therapy and Phy
- Speech-Language Pathologist
- Queensbury, NY
National Provider Identifier
1497919351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 011402
- Legal business name
- ADIRONDACK ENRICHMENT, A SPEECH PATHOLOGY OCCUPATIONAL THERAPY AND PHY
- Practice address
- 413 Bay Rd
Queensbury, NY 12804-1408 - Phone
- (518) 761-2025
- Fax
- (518) 761-2035
- NPI assigned
- Jul 10, 2008
- Last updated
- Apr 19, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Heidi Underwood, MS,CCC-SLP
- Title
- Owner/Director
- Phone
- (518) 761-2025
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 0044171 | NY | |
| Speech-Language Pathologist | 235Z00000X | 011402 | NY | Primary |
| Speech-Language Pathologist | 235Z00000X | 0163461 | NY | |
| Speech-Language Pathologist | 235Z00000X | 019159-1 | NY | |
| Speech-Language Pathologist | 235Z00000X |
Addresses
Primary practice location
413 Bay Rd
Queensbury, NY 12804-1408
Mailing address
413 Bay Rd
Queensbury, NY 12804-1408
Phone (518) 761-2025
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Physical Therapist
- Queensbury, NY
- NPI 1295835585
-
- Speech-Language Pathologist
- Glens Falls, NY
- NPI 1174787030
-
- Occupational Therapist
- Glens Falls, NY
- NPI 1780848655
-
- Speech-Language Pathologist
- Glens Falls, NY
- NPI 1972767853
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215648000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1618790400000",
"number": "1497919351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "413 BAY RD",
"city": "QUEENSBURY",
"state": "NY",
"postal_code": "128041408",
"telephone_number": "518-761-2025",
"fax_number": "518-761-2035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "413 BAY RD",
"city": "QUEENSBURY",
"state": "NY",
"postal_code": "128041408",
"telephone_number": "518-761-2025",
"fax_number": "518-761-2035"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADIRONDACK ENRICHMENT, A SPEECH PATHOLOGY OCCUPATIONAL THERAPY AND PHY",
"organizational_subpart": "NO",
"enumeration_date": "2008-07-10",
"last_updated": "2021-04-19",
"certification_date": "2021-04-19",
"status": "A",
"authorized_official_last_name": "UNDERWOOD",
"authorized_official_first_name": "HEIDI",
"authorized_official_title_or_position": "OWNER/DIRECTOR",
"authorized_official_telephone_number": "518-761-2025",
"authorized_official_credential": "MS,CCC-SLP"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": "NY",
"license": "0044171",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "011402",
"primary": true
},
{
"code": "235Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "0163461",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "019159-1",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Queensbury, NY
- Adirondack Counseling Traci Phillips LCSW PLLC
- Adirondack Cross Roads Psychology PLLC
- Adirondack Diagnostic Imaging of Queensbury
- Adirondack Enrichment
- Adirondack Enrichment
- Adirondack Health Institute
- Adirondack Manor Home for Adults (Adirondack Manor Home Care Agency)
- Adirondack Manual Physical Therapy, PLLC
- Adirondack Radiology Associates, P.C. (Adirondack Radiology Albany)
- Adirondack Radiology Associates, PC (Advanced Imaging at Baybrook)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.