Active NPI
Mark Kenneth Herbst, MS,CCC/SLP
- Speech-Language Pathologist
- Youngstown, NY
National Provider Identifier
1992014237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 007612-1
- Practice address
- 4061 Creek Rd
Youngstown, NY 14174-9609 - Phone
- (716) 754-8281
- NPI assigned
- Oct 5, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 007612-1 | NY | Primary |
Addresses
Primary practice location
4061 Creek Rd
Youngstown, NY 14174-9609
Mailing address
4061 Creek Rd
Youngstown, NY 14174-9609
Phone (716) 754-8281
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007612-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1286236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286236800000",
"number": "1992014237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4061 CREEK RD",
"city": "YOUNGSTOWN",
"state": "NY",
"postal_code": "141749609",
"telephone_number": "716-754-8281"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4061 CREEK RD",
"city": "YOUNGSTOWN",
"state": "NY",
"postal_code": "141749609",
"telephone_number": "716-754-8281"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERBST",
"first_name": "MARK",
"middle_name": "KENNETH",
"name_prefix": "Mr.",
"credential": "MS,CCC/SLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-10-05",
"last_updated": "2010-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "007612-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Youngstown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.