Jonelle Dickson-Prokopchak, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

24 Cherry St
Johnson City, NY 13790-2615

Phone

(607) 723-8313

NPI assigned

Sep 23, 2021

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)

Not enrolled

Credentials

Master of Science

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.

• The Child Development Council

  • Early Intervention Provider Agency
  • Johnson City, NY
  • NPI 1972748853
  NPD (past)

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

{
    "created_epoch": "1632355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1780355263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 PEAR TREE LN",
            "city": "DALLAS",
            "state": "PA",
            "postal_code": "186121229",
            "telephone_number": "570-574-0155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 CHERRY ST",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902615",
            "telephone_number": "607-723-8313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "42 Pear Tree Ln",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "PA",
            "postal_code": "186121229",
            "country_code": "US",
            "telephone_number": "570-574-0155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKSON-PROKOPCHAK",
        "first_name": "JONELLE",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-23",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Marie Devine
• Ludovica Di Gaetano, DO
• Wadih Diab, MD
• Catherine Dickinson, M.D.
• Rebekah Dickman, NP
• Brett Andrew Dietzman, FNP
• Lindsey Dino, M.A. CCC-SLP
• Mara Dirado, OTR/L
• James Docherty, DO
• Kearra Doheny, LMSW

• All providers in Johnson City, NY
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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.