Vivian Black, CCC SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

032067-01 Issued in NY

Practice address

1 Blue Streak Blvd
Saratoga Springs, NY 12866-5952

Phone

(518) 587-6690

NPI assigned

Oct 13, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, MA2 enrollments

Enrollment records 2

Specialty

Qualified Speech Language Pathologist

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Expressable Therapy PC

  • Speech-Language Pathologist
  • Austin, TX
  • NPI 1134875370

  MA, NY

  Medicare reassignment NPD

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

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1639629686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MATILDA ST",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122091507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BLUE STREAK BLVD",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128665952",
            "telephone_number": "518-587-6690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 N Main St",
            "address_purpose": "LOCATION",
            "city": "Sunderland",
            "state": "MA",
            "postal_code": "013759502",
            "country_code": "US",
            "telephone_number": "413-665-8717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACK",
        "first_name": "VIVIAN",
        "credential": "CCC SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-13",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "032067-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eliot L. Birnbaum, M.D.
• Andrew Gregory Bishop, DPT
• Patrick Joseph Bishop
• Marie Bitar, PA
• BJ'S Wholesale Club Inc.
• Colette Collins Blackington, FNP C
• Teresa L Blackstone, O.D.
• Deborah L Blood, RD, CDE
• Robin J Blostein, LCSWR
• Timothy Gerard Board, PA

• Speech-Language Pathologist in Saratoga Springs, NY
• Providers in Saratoga Springs, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.