Katherine Clyne, M.A., CCC/SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

028188 Issued in NY

Practice address

296 E 140TH St
Bronx, NY 10454-1125

Phone

(718) 665-2805

NPI assigned

Sep 2, 2017

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1504310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733011200000",
    "number": "1801314497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 E LINCOLN AVE APT 512",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105523528",
            "telephone_number": "631-741-1447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "296 E 140TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104541125",
            "telephone_number": "718-665-2805"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1560 Mayflower Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104615400",
            "country_code": "US",
            "telephone_number": "718-948-1900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15050 14th Rd",
            "address_purpose": "LOCATION",
            "city": "Whitestone",
            "state": "NY",
            "postal_code": "113572609",
            "country_code": "US",
            "telephone_number": "718-767-0071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLYNE",
        "first_name": "KATHERINE",
        "credential": "M.A., CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-02",
        "last_updated": "2024-12-01",
        "certification_date": "2024-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "028188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2024; 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.