Marissa Lynn Van Koppen, M.S., CCC-SLP, CBIS

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

41YS01011300 Issued in NJ

Practice address

2145 Whitesville Rd
Toms River, NJ 08755-1175

Phone

(973) 865-5404

NPI assigned

Jan 3, 2022

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)

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.

• Adaptive Home Therapy, Inc.

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  • Toms River, NJ
  • NPI 1831192673
  NPD
• Link Home Services of NJ LLC

  • Physical Therapy Clinic/Center
  • Englewood Cliffs, NJ
  • NPI 1972072585
  NPD
• Anil K Gupta MD PA

  • Cardiovascular Disease Physician
  • Toms River, NJ
  • NPI 1669459319
  NPD (past)

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

{
    "created_epoch": "1641168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1619638624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 WEBSTER AVE # 1",
            "city": "SEASIDE HEIGHTS",
            "state": "NJ",
            "postal_code": "087512334",
            "telephone_number": "973-865-5404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2145 WHITESVILLE RD",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087551175",
            "telephone_number": "973-865-5404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 Webster Ave # 1",
            "address_purpose": "LOCATION",
            "city": "Seaside Heights",
            "state": "NJ",
            "postal_code": "087512334",
            "country_code": "US",
            "telephone_number": "973-865-5404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN KOPPEN",
        "first_name": "MARISSA",
        "middle_name": "LYNN",
        "credential": "M.S., CCC-SLP, CBIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-03",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS01011300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Valentine, LCSW
• Mary Elizabeth Valentino, DPT
• Carlos Diego Valladares, MD
• Christopher Paul Vallecillo, LCSW, LCADC
• Elke Van Hooydonk, OTR/L
• Cecilia Vaquero
• Kahra Varall, PT, DPT
• Robin Varghese, DPM
• Joseph Vari
• Vikram M Varma, MD, FACEP

• Speech-Language Pathologist in Toms River, NJ
• Providers in Toms River, NJ by specialty
• Speech-Language Pathologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.