Mindy Sue Raville, M. A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

016607 Issued in NY

Practice address

2155 Route 22B
Morrisonville, NY 12962-3417

Phone

(518) 562-3847

NPI assigned

Nov 21, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1227225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227225600000",
    "number": "1740435494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 ROUTE 22B",
            "city": "MORRISONVILLE",
            "state": "NY",
            "postal_code": "129623417",
            "telephone_number": "518-562-3847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 ROUTE 22B",
            "city": "MORRISONVILLE",
            "state": "NY",
            "postal_code": "129623417",
            "telephone_number": "518-562-3847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVILLE",
        "first_name": "MINDY",
        "middle_name": "SUE",
        "name_prefix": "Miss",
        "credential": "M. A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-21",
        "last_updated": "2008-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "016607",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "1826963",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amaree Nakasia Powell
• Madison Premo, LMSW
• Alyssa Pullmain-Drollette, LCSW-R
• Grace Racicot
• Amy J Rainwater
• Alyssa Ann Recore
• Rheta Recore, LMHC
• Tristan M Ridge, RN
• Lauren M Roanley, LMHC
• Wendy J Robare, LPN

• Speech-Language Pathologist in Morrisonville, NY
• Providers in Morrisonville, 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 Nov 21, 2008; 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.