Jessica Hartz
Individual provider Active NPI Speech-Language Pathologist · Hazle Township, PA
NPI 1639508674 · NPPES record last updated Apr 23, 2025
Key facts
- NPI
- 1639508674
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SL009869 (PA)
- Practice address
- 401-403 Hazle TWP Blvd
Hazle Township, PA 18202-9604 - Phone
- (570) 455-8888
- Fax
- (570) 459-9252
- NPI assigned
- Nov 8, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250502001991 | PA | Practitioner - Qualified Speech Language Pathologist | 8426575424 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SL009869 | PA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wyoming Valley Childrens Association | Speech-Language Pathologist | Current |
Accepting new patients |
Locations
1133 Wyoming Ave
Kingston, PA 18704
Phone (570) 714-1246
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SL009869 | PA | Yes |
Addresses
Primary practice location
401-403 Hazle TWP Blvd
Hazle Township, PA 18202-9604
Mailing address
401-403 Hazle TWP Blvd
Hazle Township, PA 18202
Phone (570) 455-8888
Other practice location 1
1133 Wyoming Ave
Kingston, PA 18704-4003
Phone (570) 714-1246
Other providers in Hazle Township, PA
- Greater Hazleton Ambulance LLC
- Greater Hazleton Gastroenterology, P.C.
- Greco Chiropractic, P.C.
- Colleen Marie Haggerty-Barron
- Larry Gene Halye Jr.
- Edward Joseph Harvilla
- Hazleton Area SD
- Hazleton Endoscopy Center, Inc.
- Hazleton Eye Center, Inc.
- Hazleton Physical Therapy, LLC
All providers in Hazle Township, PA · Speech-Language Pathologist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 23, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.