Kimberly Black, MA CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Monmouth Beach, NJ
NPI 1962769919 · NPPES record last updated Feb 8, 2016
Key facts
- NPI
- 1962769919
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 41YS00271800 (NJ)
- Practice address
- 32 Monmouth Pkwy
Monmouth Beach, NJ 07750-1129 - Phone
- (732) 673-6725
- NPI assigned
- Apr 16, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41YS00271800 | NJ | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 41YS00271800 | NJ | Yes |
Addresses
Primary practice location
32 Monmouth Pkwy
Monmouth Beach, NJ 07750-1129
Mailing address
32 Monmouth Pkwy
Monmouth Beach, NJ 07750-1129
Phone (732) 673-6725
Other providers in Monmouth Beach, NJ
- Allison Villane DPT LLC
- Tara Arhakos
- Eugenia Vottea Crincoli
- Dental Health Center of Monmouth Beach
- Dochas Rehabilitation
- Michelle L Gray
- Maria Teresa Gulli
All providers in Monmouth Beach, NJ · Speech-Language Pathologist in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.