Active NPI
Alyssa Clark
- Speech-Language Pathologist
- Marlton, NJ
National Provider Identifier
1891731196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 41YSO269900
- Practice address
- 9 Lakefield Dr
Marlton, NJ 08053-5321 - Phone
- (856) 810-2677
- NPI assigned
- Jun 22, 2006
- Sex
- Female
- Sole proprietor
- No
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 | 41YSO269900 | NJ | Primary |
Addresses
Primary practice location
9 Lakefield Dr
Marlton, NJ 08053-5321
Mailing address
9 Lakefield Dr
Marlton, NJ 08053-5321
Phone (856) 810-2677
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41YSO269900 | NJ | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891731196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 LAKEFIELD DR",
"city": "MARLTON",
"state": "NJ",
"postal_code": "080535321",
"telephone_number": "856-810-2677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 LAKEFIELD DR",
"city": "MARLTON",
"state": "NJ",
"postal_code": "080535321",
"telephone_number": "856-810-2677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "ALYSSA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NJ",
"license": "41YSO269900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marlton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.