Stacey Lyn Sheridan, MS CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

012752-1 Issued in NY

Practice address

76 Granada Cir
Mount Sinai, NY 11766-2811

Phone

(917) 887-1843

NPI assigned

Oct 31, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2000

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1225411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743292800000",
    "number": "1902059108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 GRANADA CIR",
            "city": "MOUNT SINAI",
            "state": "NY",
            "postal_code": "117662811",
            "telephone_number": "917-887-1843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 GRANADA CIR",
            "city": "MOUNT SINAI",
            "state": "NY",
            "postal_code": "117662811",
            "telephone_number": "917-887-1843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERIDAN",
        "first_name": "STACEY",
        "middle_name": "LYN",
        "name_prefix": "Mrs.",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-31",
        "last_updated": "2025-03-30",
        "certification_date": "2025-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "012752-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth K Schwartz, LCAT MT-BC
• Leidy Laura Sedano
• Ariele Sezanayev
• Allison Margaret Shea
• Valerie Sheehan, NP
• Jillian Smith
• Kimberly Marie Smith, MA CCCSLP TSHH
• Patrick Joseph Smith
• Mark David Solomon, M.D.
• Connie M Spuller, PH.D.

• Speech-Language Pathologist in Mount Sinai, NY
• Providers in Mount Sinai, 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 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.