Individual provider Active NPI

Michelle L Kienzle, M.S.

  • Speech-Language Pathologist
  • Brooklyn, NY
National Provider Identifier
1518259357
Registry record updated May 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
020950 Issued in NY
Practice address
1663 E 17TH St
Brooklyn, NY 11229-1259
Phone
(718) 338-3838
NPI assigned
May 12, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2011

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 020950 NY Primary

Addresses

Primary practice location

1663 E 17TH St
Brooklyn, NY 11229-1259

Mailing address

355 S End Ave
Apt. 25G
New York, NY 10280-1005
Phone (813) 892-7086

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
020950NYMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305158400000",
    "number": "1518259357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 S END AVE",
            "address_2": "APT. 25G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "102801005",
            "telephone_number": "813-892-7086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1663 E 17TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291259",
            "telephone_number": "718-338-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIENZLE",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-12",
        "last_updated": "2011-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "020950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2011; 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.