Jenna Lee Gillen, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

029146 Issued in NY

Practice address

400 Lake St
Ithaca, NY 14850-2132

Phone

(607) 274-2101

NPI assigned

Sep 24, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ithaca City School District

  • Local Education Agency (LEA)
  • Ithaca, NY
  • NPI 1225185317
  NPD (past)

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

{
    "created_epoch": "1569283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1891346599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 N MADISON ST",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134403418",
            "telephone_number": "315-271-7150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 LAKE ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148502132",
            "telephone_number": "607-274-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLEN",
        "first_name": "JENNA",
        "middle_name": "LEE",
        "name_prefix": "Miss",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-24",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "029146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION",
            "identifier": "14105406",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maida Erika Gierasch
• Sarah Anne Giewont, OTR/L
• Donna G Gilbert, LPN
• Louise May Gill, MPT
• Magdalen Anne Gillard, OT-L
• Jennifer L Gilmour, RPH
• Karen Dashiff Gilovich, M.S., L.C.S.W.
• Mary Gitlin, RN
• Marc Gittelson, RN
• Cindy Lee Glanville

• Speech-Language Pathologist in Ithaca, NY
• Providers in Ithaca, 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 Sep 24, 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.