Active NPI
Kristen Jo Koshenko, M.S. CCC/SLP
- Speech-Language Pathologist
- Saint Clairsville, OH
National Provider Identifier
1790184893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP6195
- Practice address
- 108 Woodrow Ave
Saint Clairsville, OH 43950-1567 - Phone
- (740) 695-0783
- NPI assigned
- Aug 14, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP6195 | OH | Primary |
Addresses
Primary practice location
108 Woodrow Ave
Saint Clairsville, OH 43950-1567
Mailing address
44421 Main Street
Saint Clairsville, OH 43950
Phone (740) 695-9350
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 |
|---|---|---|---|
| SP6195 | OH | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1498694400000",
"number": "1790184893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44421 MAIN STREET",
"city": "SAINT CLAIRSVILLE",
"state": "OH",
"postal_code": "43950",
"telephone_number": "740-695-9350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 WOODROW AVE",
"city": "SAINT CLAIRSVILLE",
"state": "OH",
"postal_code": "439501567",
"telephone_number": "740-695-0783"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOSHENKO",
"first_name": "KRISTEN",
"middle_name": "JO",
"name_prefix": "Mrs.",
"credential": "M.S. CCC/SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-14",
"last_updated": "2017-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OH",
"license": "SP6195",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Clairsville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.