Active NPI
Mia L Camen, MA, CCC-SLP
- Speech-Language Pathologist
- Roosevelt, NY
National Provider Identifier
1831405026
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 014910
- Practice address
- 60 Underhill Ave.
Roosevelt, NY 11575-2334 - Phone
- (516) 345-7500
- NPI assigned
- Aug 25, 2010
- Last updated
- May 13, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 | 014910 | NY | Primary |
Addresses
Primary practice location
60 Underhill Ave.
Roosevelt, NY 11575-2334
Mailing address
60 Underhill Ave.
Roosevelt, NY 11575-2334
Phone (516) 345-7500
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014910 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620864000000",
"number": "1831405026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 UNDERHILL AVE.",
"city": "ROOSEVELT",
"state": "NY",
"postal_code": "115752334",
"telephone_number": "516-345-7500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60 UNDERHILL AVE.",
"city": "ROOSEVELT",
"state": "NY",
"postal_code": "115752334",
"telephone_number": "516-345-7500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMEN",
"first_name": "MIA",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "MA, CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-08-25",
"last_updated": "2021-05-13",
"certification_date": "2021-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "014910",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roosevelt, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.