Kemi Doris-Destinie Pollock, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

031871 Issued in NY

Practice address

9 Cromwell CT
Stafford, VA 22554-8810

Phone

(540) 422-9066

NPI assigned

Sep 23, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Essential OT PT SLP and Psychology Services PLLCGroup PAC ID 9133486301, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Essential OT, PT, SLP & Psychology Services, PLLC

  • Contractor
  • Baldwin, NY
  • NPI 1093226805
  Medicare reassignment Care Compare group NPD
• Complete SLP, OT, PT & Psychology Services, PLLC

  • Contractor
  • Bronx, NY
  • NPI 1437616026
  Medicare reassignment NPD
• Comprehensive OT, PT, SLP & Adult Health NP Services, PLLC

  • Occupational Therapist
  • Newburgh, NY
  • NPI 1619622461
  Medicare reassignment
• Essential Therapy Services of NJ

  • Occupational Therapist
  • Rockaway, NJ
  • NPI 1730852070

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1600819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1730795865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CROMWELL CT",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225548810",
            "telephone_number": "540-422-9066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 CROMWELL CT",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225548810",
            "telephone_number": "540-422-9066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLOCK",
        "first_name": "KEMI",
        "middle_name": "DORIS-DESTINIE",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-23",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "02149L",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202010087",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "031871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taneisha Pittman
• Brittany Placencia
• Playtime Pediatric Dentistry and Orthodontics,PLLC (Lifetime Dental Care)
• Inina Plucer-Rosario, M.ED.
• Poise Integrative Psychiatry
• Cynthia Henderson Porter, LCSW
• Zoila Portillo
• Tyler Robert Porzeinski, M.A., BCBA
• Renee D Powell
• Tamara Ann Powell, LCSW, CSOTP, RPT

• Speech-Language Pathologist in Stafford, VA
• Providers in Stafford, VA by specialty
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.