Nicole Nicolette-Walz, MS CCC SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

010183 Issued in NY

Practice address

2 Fountain St Ste 109
Clinton, NY 13323-1725

Phone

(315) 858-6090

Fax

(315) 853-3190

NPI assigned

Dec 17, 2008

Last updated

Dec 17, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Speech Language Therapy of Central New York LLC

  • Speech-Language Pathologist
  • Frankfort, NY
  • NPI 1649723727
  Medicare reassignment NPD
• Building Blocks Learning Center,LLC

  • Early Intervention Provider Agency
  • Clinton, NY
  • NPI 1760628754
  NPD (past)

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

{
    "created_epoch": "1229472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229472000000",
    "number": "1588800718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 FOUNTAIN ST STE 109",
            "city": "CLINTON",
            "state": "NY",
            "postal_code": "133231725",
            "telephone_number": "315-858-6090",
            "fax_number": "315-853-3190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 FOUNTAIN ST STE 109",
            "city": "CLINTON",
            "state": "NY",
            "postal_code": "133231725",
            "telephone_number": "315-858-6090",
            "fax_number": "315-853-3190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLETTE-WALZ",
        "first_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "MS CCC SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-17",
        "last_updated": "2008-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "010183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Natalini, M.ED
• Ashley Neier
• Shannon Jean Nelson, RDMS
• Taylor Leigh Nethaway, PT, DPT
• Gabriella C Neuberger
• Michelle T Nunno-Evans, PT,DPT
• Amy Lynn O'Brien
• Michelle Puleo O'Brien, MS,CCC-SLP
• Olive Tree Medical Associates PLLC
• Virginia Oliver, PT

• Speech-Language Pathologist in Clinton, NY
• Providers in Clinton, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2008; 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.

Verify at the official NPI Registry.