Amanda Izen, M.A., CCC-SLP, TSSLD

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

14295359 Issued in NY

Practice address

48 Colby Dr
Dix Hills, NY 11746-8348

Phone

(631) 560-5080

NPI assigned

May 12, 2020

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 identifiers 1

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": "1589241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1952923948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 COLBY DR",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117468348",
            "telephone_number": "631-560-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 COLBY DR",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117468348",
            "telephone_number": "631-560-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZEN",
        "first_name": "AMANDA",
        "credential": "M.A., CCC-SLP, TSSLD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-12",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "14295359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN SPEECH HEARING LANGUAGE ASSOCIATION",
            "identifier": "14295359",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ketty Hova-O'Donnell, PT
• Haley Farrah Howard, DDS
• Alexis Huezo
• Zachary Daniel Huntington, LMSW
• Imac NP in Family Health PLLC
• Jessica Lynn Jacobs
• Tricia Jaichan
• Marvele M Jean-Baptiste
• Tiffanie Edlyne Jean-Louis, LPN
• Lei Jing, RN

• Speech-Language Pathologist in Dix Hills, NY
• Providers in Dix Hills, 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 May 12, 2020; 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.