Individual provider Active NPI

Allysa Stock, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Liverpool, NY
National Provider Identifier
1902578073
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
031083 Issued in NY
Practice address
4820 W Taft Rd Ste 202
Liverpool, NY 13088-2806
Phone
(315) 552-0406
Fax
(315) 634-6230
NPI assigned
Sep 28, 2021
Last updated
Feb 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 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 031083 NY Primary

Addresses

Primary practice location

4820 W Taft Rd Ste 202
Liverpool, NY 13088-2806

Mailing address

365 Ridley Rd
Newark, NY 14513-9107

Other practice location 1

882 Ny-13
Cortland, NY 13045
Phone (607) 753-9375 ext. 165

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
031083NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1632787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1902578073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 RIDLEY RD",
            "city": "NEWARK",
            "state": "NY",
            "postal_code": "145139107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4820 W TAFT RD STE 202",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130882806",
            "telephone_number": "315-552-0406",
            "fax_number": "315-634-6230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "882 NY-13",
            "address_purpose": "LOCATION",
            "city": "Cortland",
            "state": "NY",
            "postal_code": "13045",
            "country_code": "US",
            "telephone_number": "607-753-9375 x165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOCK",
        "first_name": "ALLYSA",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-28",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "031083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.