Individual provider Active NPI

Ellen Ann Storm, MS, CCC/SLP

  • Speech-Language Pathologist
  • Valley Stream, NY
National Provider Identifier
1538304647
Registry record updated Dec 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
012851 Issued in NY
Practice address
594 Hook St
Valley Stream, NY 11581-3504
Phone
(516) 448-1879
NPI assigned
Dec 4, 2008
Last updated
Dec 4, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2008

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 012851 NY Primary

Addresses

Primary practice location

594 Hook St
Valley Stream, NY 11581-3504

Mailing address

594 Hook St
North Woodmere
Valley Stream, NY 11581-3504
Phone (516) 448-1879

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
012851NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1228348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228348800000",
    "number": "1538304647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "594 HOOK ST",
            "address_2": "NORTH WOODMERE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115813504",
            "telephone_number": "516-448-1879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "594 HOOK ST",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115813504",
            "telephone_number": "516-448-1879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STORM",
        "first_name": "ELLEN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MS, CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-04",
        "last_updated": "2008-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "012851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2008; 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.