Stephanie Jack, MS CCC-SLP/L

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SL012084 Issued in PA

Practice address

20397 Route 19 Ste 30
Cranberry TWP, PA 16066-6102

Phone

(855) 887-7332

NPI assigned

Oct 27, 2019

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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 and National Provider Directory roles.

• Talktime Speech Therapy, LLC

  • Clinic/Center
  • Beaver Falls, PA
  • NPI 1255570438
  NPD

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

{
    "created_epoch": "1572134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572134400000",
    "number": "1609419233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20397 ROUTE 19 STE 30",
            "city": "CRANBERRY TWP",
            "state": "PA",
            "postal_code": "160666102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20397 ROUTE 19 STE 30",
            "city": "CRANBERRY TWP",
            "state": "PA",
            "postal_code": "160666102",
            "telephone_number": "855-887-7332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACK",
        "first_name": "STEPHANIE",
        "credential": "MS CCC-SLP/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-27",
        "last_updated": "2019-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL012084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Farah Hyder, NUTRITIONIST
• Informed Care Solutions, Inc
• Katie Lynn Ingold
• Philip Iozzi
• Lauren Isaacs, MS, CCC-SLP
• Benjamin P Jagiello, M.D.
• Shahnaz Jagiello, PA-C
• Kimberly Jahoda, RN
• Jamie Mixter Counseling
• Kenneth W Johnson

• Speech-Language Pathologist in Cranberry TWP, PA
• Providers in Cranberry TWP, PA by specialty
• Speech-Language Pathologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2019; 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.