Individual provider Active NPI

Stephanie Rachel Cohen

  • Speech-Language Pathologist
  • Jacksonville, FL
National Provider Identifier
1942966528
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA20300 Issued in FL
Practice address
3901 University Blvd S
Jacksonville, FL 32216-4312
Phone
(904) 345-7310
NPI assigned
Nov 9, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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 SA20300 FL Primary

Addresses

Primary practice location

3901 University Blvd S
Jacksonville, FL 32216-4312

Mailing address

316 N Lombardy Loop
St Johns, FL 32259-5266
Phone (901) 288-4032

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL stephanieclein@gmail.com

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
SA20300FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1636416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1942966528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 N LOMBARDY LOOP",
            "city": "ST JOHNS",
            "state": "FL",
            "postal_code": "322595266",
            "telephone_number": "901-288-4032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164312",
            "telephone_number": "904-345-7310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "STEPHANIE",
        "middle_name": "RACHEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-09",
        "last_updated": "2023-11-09",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA20300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "stephanieclein@gmail.com",
            "affiliation": "N",
            "address_1": "2351 Ridgemont Dr",
            "city": "Birmingham",
            "state": "AL",
            "country_code": "US",
            "postal_code": "352441206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; 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.