Jeanette Yavaldakis, M.S., SLP-CCC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

41YS00855600 Issued in NJ

Practice address

91 Lincoln Ave
Pearl River, NY 10965-1708

Phone

(845) 536-9536

NPI assigned

Dec 5, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Jeanette Yavaldakis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1480896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551830400000",
    "number": "1861936254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 NOYES ST",
            "city": "PEARL RIVER",
            "state": "NY",
            "postal_code": "109652925",
            "telephone_number": "845-536-9536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 LINCOLN AVE",
            "city": "PEARL RIVER",
            "state": "NY",
            "postal_code": "109651708",
            "telephone_number": "845-536-9536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAVALDAKIS",
        "first_name": "JEANETTE",
        "name_prefix": "Mrs.",
        "credential": "M.S., SLP-CCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-05",
        "last_updated": "2019-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "028264",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00855600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEANETTE",
            "last_name": "YAVALDAKIS",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Speech-Language Pathologist in Pearl River, NY
• Providers in Pearl River, 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 Mar 6, 2019; 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.