Ivrielle M Dworkis, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

41YS00744300 Issued in NJ

Practice address

13-11 Ellis Ave
Fair Lawn, NJ 07410-6201

Phone

(646) 241-6766

NPI assigned

Aug 16, 2023

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

Other identifiers 1

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": "1692144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1699558353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13-11 ELLIS AVE",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074106201",
            "telephone_number": "646-241-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13-11 ELLIS AVE",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074106201",
            "telephone_number": "646-241-6766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DWORKIS",
        "first_name": "IVRIELLE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-16",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00744300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN SPEECH/LANGUAGE HEARING ASSOCIATION (ASHA)",
            "identifier": "12154630",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Fair Lawn, NJ
• Providers in Fair Lawn, NJ by specialty
• Speech-Language Pathologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.