Jaclyn Gretsky, MA CCC/SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SL008586 Issued in PA

Practice address

44 Donaldson Rd
Tremont, PA 17981-1424

Phone

(570) 695-3141

Fax

(570) 695-2264

NPI assigned

Nov 24, 2013

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

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1385251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385251200000",
    "number": "1679903926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 DONNA CIR",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179018876",
            "telephone_number": "570-385-4252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 DONALDSON RD",
            "city": "TREMONT",
            "state": "PA",
            "postal_code": "179811424",
            "telephone_number": "570-695-3141",
            "fax_number": "570-695-2264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRETSKY",
        "first_name": "JACLYN",
        "name_prefix": "Mrs.",
        "credential": "MA CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-24",
        "last_updated": "2013-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL008586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Tremont, PA
• Providers in Tremont, PA by specialty
• Speech-Language Pathologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2013; 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.