Jaclyn Corson, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

029058 Issued in NY

Practice address

68 Harris Bushville Road
Harris, NY 10924

Phone

(732) 687-6556

NPI assigned

Aug 15, 2022

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1609594837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 HARRIS BUSHVILLE ROAD",
            "city": "HARRIS",
            "state": "NY",
            "postal_code": "10924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 HARRIS BUSHVILLE ROAD",
            "city": "HARRIS",
            "state": "NY",
            "postal_code": "10924",
            "telephone_number": "732-687-6556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORSON",
        "first_name": "JACLYN",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "029058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Chew, MS CCC-SLP
• Umar I Chouhdry, MD
• Ariel Frank Cohen, D.D.S.
• Jeffrey M Cohen, D.D.S.
• Brittnie Connolly, PA-C
• Annastacia W Cowles, FNP
• Muhammad Atif Dar, MD
• Melissa Druke, FNP
• James Dwyer, MD
• Rafik A El-Sabrout, M.D.

• All providers in Harris, NY
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; 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.