Individual provider Active NPI

Angelique Licari

  • Speech-Language Pathologist
  • Oakdale, NY
National Provider Identifier
1902272214
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
132 Vanderbilt Blvd
Oakdale, NY 11769-2033
Phone
(631) 790-5282
NPI assigned
Aug 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Primary

Addresses

Primary practice location

132 Vanderbilt Blvd
Oakdale, NY 11769-2033

Mailing address

132 Vanderbilt Blvd
Oakdale, NY 11769-2033

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

Practice roles

OrganizationSpecialtyStatusNew patients
Learn. Eat. Talk. Smile. Speech Therapy Speech-Language Pathologist CurrentSince Nov 1, 2022 Accepting new patients
South Shore Center for Speech, Language and Swallowing Disorders, LLP Past Accepting new patients
South Shore Speech Language and Swallowing Disorders PLLC Speech-Language Pathologist PastSince Oct 12, 2009 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1902272214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 VANDERBILT BLVD",
            "city": "OAKDALE",
            "state": "NY",
            "postal_code": "117692033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 VANDERBILT BLVD",
            "city": "OAKDALE",
            "state": "NY",
            "postal_code": "117692033",
            "telephone_number": "631-790-5282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICARI",
        "first_name": "ANGELIQUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-20",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakdale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; 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.