Michelle Fireworker, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

022340-1 Issued in NY

Practice address

923 Cliffside Ave
Valley Stream, NY 11581-3049

Phone

(516) 633-3688

NPI assigned

Sep 5, 2014

Last updated

Sep 5, 2014By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1409875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409875200000",
    "number": "1770984007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "923 CLIFFSIDE AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115813049",
            "telephone_number": "516-633-3688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 CLIFFSIDE AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115813049",
            "telephone_number": "516-633-3688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIREWORKER",
        "first_name": "MICHELLE",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-05",
        "last_updated": "2014-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "022340-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Valley Stream, NY
• Providers in Valley Stream, 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 Sep 5, 2014; 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.