Individual provider Active NPI

Marnelle Stephen, CCC-SLP

  • Speech-Language Pathologist
  • Staten Island, NY
National Provider Identifier
1972047405
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
74 Croft PL Apt 1
Staten Island, NY 10314-6508
Phone
(347) 279-1280
NPI assigned
Dec 19, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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 Primary

Addresses

Primary practice location

74 Croft PL Apt 1
Staten Island, NY 10314-6508

Mailing address

74 Croft PL Apt 1
Staten Island, NY 10314-6508
Phone (347) 279-1280

Other practice location 1

1417 E 87th St
Brooklyn, NY 11236-5137
Phone (347) 279-1280

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

NPI Registry JSON

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

{
    "created_epoch": "1482105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1972047405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 CROFT PL APT 1",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146508",
            "telephone_number": "347-279-1280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 CROFT PL APT 1",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146508",
            "telephone_number": "347-279-1280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1417 E 87th St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112365137",
            "country_code": "US",
            "telephone_number": "347-279-1280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPHEN",
        "first_name": "MARNELLE",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-19",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; 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.