Katelyn Pryal Mautschke, M.A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

020632-1 Issued in NY

Practice address

76 Newtown LN
East Hampton, NY 11937-2405

Phone

(631) 329-4112

NPI assigned

Mar 2, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• East End Kids Psy, SLP, OT & PT Serv. PLLC

  • Counseling Psychologist
  • Southampton, NY
  • NPI 1518256619
  NPD (past)
• East End Kids Therapy, Inc.

  • Home Health Agency
  • Southampton, NY
  • NPI 1265562979
  NPD (past)

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

{
    "created_epoch": "1299024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1649578519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 GRANADA AVE",
            "city": "MONTAUK",
            "state": "NY",
            "postal_code": "119545147",
            "telephone_number": "631-678-8534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 NEWTOWN LN",
            "city": "EAST HAMPTON",
            "state": "NY",
            "postal_code": "119372405",
            "telephone_number": "631-329-4112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAUTSCHKE",
        "first_name": "KATELYN",
        "middle_name": "PRYAL",
        "name_prefix": "Ms.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-02",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "020632-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECH-LANGUAGE PATHOLOGIST LICENSE",
            "identifier": "020632-1",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INITIAL CERTIFICATION AS TEACHER FOR STUDENTS WITH SPEECH-LANGUAGE DISABILITIES",
            "identifier": "2035509",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Luxottica Retail North America Inc
• Robert Frank Lynch Jr., CASAC
• Adele Stewart Macmillan, LCSW
• David Anthony Mambrino, DDS
• Lynette Marichal, S.L.P.-C.C.C.-TSLD
• Alexandra Bonney McAuliffe
• John Joseph McGovern, LCSW, PH.D.
• Erin M. McKay, ANP
• Natalie Meisinger, LIMITED-PERMIT MHC
• Karen Melnick, LCSW

• Speech-Language Pathologist in East Hampton, NY
• Providers in East Hampton, 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 Dec 11, 2023; 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.