Open Door Speech Therapy Services, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

OPEN DOOR SPEECH THERAPY SERVICES, LLC

Practice address

47 Blaisdell Ave
Coeymans, NY 12045-7702

Phone

(518) 334-9546

NPI assigned

Aug 14, 2020

Last updated

Jan 29, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Timothy L Haller, CCC-SLPNPI 1285703041

Title

Speech Pathologist

Phone

(518) 334-9546

Specialties & licenses 1

Addresses

Other names 1

• The Open Door Speech Therapy Services, LLC Other name

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Timothy Leonard Haller, SLP

  • Speech-Language Pathologist
  • Ravena, NY
  • NPI 1285703041
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1597363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611878400000",
    "number": "1841801529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 761",
            "city": "COEYMANS",
            "state": "NY",
            "postal_code": "120450761",
            "telephone_number": "518-334-9546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 BLAISDELL AVE",
            "city": "COEYMANS",
            "state": "NY",
            "postal_code": "120457702",
            "telephone_number": "518-334-9546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN DOOR SPEECH THERAPY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-14",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A",
        "authorized_official_last_name": "HALLER",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SPEECH PATHOLOGIST",
        "authorized_official_telephone_number": "518-334-9546",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Open Door Speech Therapy Services, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Hannah Louise Barry, MSW
• Stacey A Battenfeld
• Michelle Katherine Deleon, MSED
• Audry L June, MS CCC SLP
• Bryanne Marriello

• Speech-Language Pathologist in Coeymans, NY
• Providers in Coeymans, 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 Jan 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.