Organization Active NPI

Speech, Language & Swallowing Consultants P.C.

  • Speech-Language Pathologist
  • Southold, NY
National Provider Identifier
1568413771
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
016296-1 Issued in NY
Legal business name
SPEECH, LANGUAGE & SWALLOWING CONSULTANTS P.C.
Practice address
57190 Main Rd
Southold, NY 11971-4750
Phone
(631) 765-3620
NPI assigned
May 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Lisa Ann Kelly, M.S. CCC-SLP
Title
President
Phone
(631) 765-3620

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 235Z00000X 016296-1 NY Primary
Speech-Language PathologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 235Z00000X 016352-1 NY

Addresses

Primary practice location

57190 Main Rd
Southold, NY 11971-4750

Mailing address

57190 Main Rd
P.O. Box 1562
Southold, NY 11971-4750
Phone (631) 765-3620

National Provider Directory

National Provider Directory

Locations

57190 Route 25
Southold, NY 11971
Phone (631) 626-1006

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1568413771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57190 MAIN RD",
            "address_2": "P.O. BOX 1562",
            "city": "SOUTHOLD",
            "state": "NY",
            "postal_code": "119714750",
            "telephone_number": "631-765-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57190 MAIN RD",
            "city": "SOUTHOLD",
            "state": "NY",
            "postal_code": "119714750",
            "telephone_number": "631-765-3620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEECH, LANGUAGE & SWALLOWING CONSULTANTS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-765-3620",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.S. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "016296-1",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "016352-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southold, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.