Stephanie Lynn-Poole Jodice, M.S.-CCC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

004048 Issued in CT

Practice address

1 Meagan Cir
Ellington, CT 06029-3670

Phone

(413) 636-9972

NPI assigned

Dec 6, 2010

Last updated

Aug 9, 2021By the provider in NPPES

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1291593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1649573106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEAGAN CIR",
            "city": "ELLINGTON",
            "state": "CT",
            "postal_code": "060293670",
            "telephone_number": "413-636-9972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEAGAN CIR",
            "city": "ELLINGTON",
            "state": "CT",
            "postal_code": "060293670",
            "telephone_number": "413-636-9972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JODICE",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN-POOLE",
        "name_prefix": "Miss",
        "credential": "M.S.-CCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-06",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CT",
            "license": "004048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Ellington, CT
• Providers in Ellington, CT by specialty
• Speech-Language Pathologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; 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.