Individual provider Active NPI

Violetta Glikstein, SLP

  • Speech-Language Pathologist
  • Watertown, MA
National Provider Identifier
1932424637
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8099 Issued in MA
Practice address
32 Whites Ave Apt F5503
Watertown, MA 02472-4305
Phone
(347) 782-3665
NPI assigned
Apr 6, 2010
Last updated
Jan 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X
Speech-Language Pathologist 235Z00000X 019362 NY
Speech-Language Pathologist 235Z00000X 8099 MA Primary

Addresses

Primary practice location

32 Whites Ave Apt F5503
Watertown, MA 02472-4305

Mailing address

83 Clematis Ave
Waltham, MA 02453-7012
Phone (347) 792-3665

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

LicenseStateTypeSpecialty
8099MAMDClinical Psychologist
019362NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Speechguru LLC Speech-Language Pathologist CurrentSince Feb 7, 2021 Accepting new patients
Speechguru LLC Single Specialty PastSince Jan 17, 2021 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1270512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1932424637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 CLEMATIS AVE",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024537012",
            "telephone_number": "347-792-3665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 WHITES AVE APT F5503",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024724305",
            "telephone_number": "347-782-3665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLIKSTEIN",
        "first_name": "VIOLETTA",
        "name_prefix": "Ms.",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-06",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "019362",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "8099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; 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.