Active NPI
Karissa Jessi Hall, MS, CCC-SLP
- Speech-Language Pathologist
- Indian Lake, NY
National Provider Identifier
1720649072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 029253
- Practice address
- 163 Stanton Rd
Indian Lake, NY 12842-7778 - Phone
- (315) 221-3466
- NPI assigned
- Jun 27, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 5904 | CT | |
| Speech-Language Pathologist | 235Z00000X | 029253 | NY | Primary |
Addresses
Primary practice location
163 Stanton Rd
Indian Lake, NY 12842-7778
Mailing address
PO Box 236
Indian Lake, NY 12842-0236
Phone (203) 550-5404
Other practice location 1
118 Freeville Rd
Dryden, NY 13053-9625
Phone (607) 844-8694
Other names 1
- Karissa Ann Moccio
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 029253 | NY | MD | Physical Therapist |
| 5904 | CT | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693267200000",
"number": "1720649072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 236",
"city": "INDIAN LAKE",
"state": "NY",
"postal_code": "128420236",
"telephone_number": "203-550-5404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "163 STANTON RD",
"city": "INDIAN LAKE",
"state": "NY",
"postal_code": "128427778",
"telephone_number": "315-221-3466"
}
],
"practiceLocations": [
{
"address_1": "118 Freeville Rd",
"address_purpose": "LOCATION",
"city": "Dryden",
"state": "NY",
"postal_code": "130539625",
"country_code": "US",
"telephone_number": "607-844-8694",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HALL",
"first_name": "KARISSA",
"middle_name": "JESSI",
"credential": "MS, CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-06-27",
"last_updated": "2023-08-29",
"certification_date": "2023-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CT",
"license": "5904",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "029253",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KARISSA",
"last_name": "MOCCIO",
"middle_name": "ANN",
"credential": "MS, CCC-SLP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Indian Lake, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.