Kaitlin Cooley, M.A. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

027239 Issued in NY

Practice address

35 Kreamer St
Bellport, NY 11713-2337

Phone

(631) 730-1627

NPI assigned

Nov 13, 2017

Last updated

Apr 14, 2020By the provider in NPPES

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

Electronic endpoints 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Little Angels Center, Inc

  • Speech-Language Pathologist
  • Medford, NY
  • NPI 1588719041
  NPD (past)

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

{
    "created_epoch": "1510531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586822400000",
    "number": "1699288761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 KEMI LN",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117821150",
            "telephone_number": "631-707-2698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 KREAMER ST",
            "city": "BELLPORT",
            "state": "NY",
            "postal_code": "117132337",
            "telephone_number": "631-730-1627"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "235 Blue Point Ave",
            "address_purpose": "LOCATION",
            "city": "Blue Point",
            "state": "NY",
            "postal_code": "117151261",
            "country_code": "US",
            "telephone_number": "631-363-5794",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOLEY",
        "first_name": "KAITLIN",
        "name_prefix": "Mrs.",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-13",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "027239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcooley@southcountry.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "35 Kreamer St",
            "city": "Bellport",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117132337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Darlene Ciresi
• Mary Christine Climo, LMSW
• Melissa Cohen, LCSW
• Stephanie Columbia, LCSW-R, BCBA
• Connecting for Purpose
• Tammy Sue Cornacchiulo, R.N.
• Gabrielle Maria Coyne, LMSW
• CVS Albany LLC (CVS Pharmacy # 00848)
• Daniel Zito DMD PLLC (Bellport Village Dentist)
• Conrado De la Garza

• Speech-Language Pathologist in Bellport, NY
• Providers in Bellport, 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 Apr 14, 2020; 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.