Andrea Lynn Phillips, M.A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

012436-1 Issued in NY

Practice address

1635 Ohio St
Watertown, NY 13601-3032

Phone

(315) 786-7285

NPI assigned

Apr 2, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Andrea Lynn Jones Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1238630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238630400000",
    "number": "1912149196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28518 COUNTY ROUTE 192",
            "city": "REDWOOD",
            "state": "NY",
            "postal_code": "136794136",
            "telephone_number": "315-486-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 OHIO ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136013032",
            "telephone_number": "315-786-7285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "ANDREA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-02",
        "last_updated": "2009-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "012436-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "JONES",
            "middle_name": "LYNN",
            "prefix": "MISS",
            "credential": "M.A., CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jill Christine Peterson, DO
• Carl Anthony Petitto, OT/L
• Michael B Peyser, MD
• Sirina Phelps
• Tara Phillips-McAuliffe, LCSW-R
• Lila Phillips
• Norma Phillips
• Erin Lee Phinney, NPP
• Physician to Women, PC
• Robert James Pickeral Jr., PAC

• Speech-Language Pathologist in Watertown, NY
• Providers in Watertown, 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 Apr 2, 2009; 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.