Active NPI
Kenneth Joel Sierra Caceres
- Speech-Language Pathologist
- Fair Lawn, NJ
National Provider Identifier
1609746593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- TL-4957
- Practice address
- 12-15 Saddle River Rd
Fair Lawn, NJ 07410-5808 - Phone
- (201) 797-9522
- NPI assigned
- Nov 6, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | TL-4957 | NJ | Primary |
Addresses
Primary practice location
12-15 Saddle River Rd
Fair Lawn, NJ 07410-5808
Mailing address
4 1/2 Bellevue Ter
Morristown, NJ 07960-9466
Phone (973) 462-1674
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TL-4957 | NJ | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1762387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762387200000",
"number": "1609746593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 1/2 BELLEVUE TER",
"city": "MORRISTOWN",
"state": "NJ",
"postal_code": "079609466",
"telephone_number": "973-462-1674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12-15 SADDLE RIVER RD",
"city": "FAIR LAWN",
"state": "NJ",
"postal_code": "074105808",
"telephone_number": "201-797-9522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIERRA CACERES",
"first_name": "KENNETH",
"middle_name": "JOEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-11-06",
"last_updated": "2025-11-06",
"certification_date": "2025-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NJ",
"license": "TL-4957",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fair Lawn, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.