Jennifer Ann Wolak, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

0137461 Issued in NY

Practice address

1020 Mary St
Utica, NY 13501-1930

Phone

(315) 724-6907

NPI assigned

Jul 12, 2010

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

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• State of New York Comptrollers Office

  • Developmental Disabilities Clinic/Center
  • Staten Island, NY
  • NPI 1750469912
  Medicare reassignment
• State of New York Comptrollers Office

  • Physical Therapist
  • Albany, NY
  • NPI 1346710985

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1278892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278892800000",
    "number": "1992017511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 MAIN ST",
            "city": "NEW YORK MILLS",
            "state": "NY",
            "postal_code": "134171253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 MARY ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135011930",
            "telephone_number": "315-724-6907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLAK",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-12",
        "last_updated": "2010-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "0137461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Lee Wise
• Michelle Marie Wisniewski, DDS
• Sienna Wisse, OTR/L
• James Withers, DO
• Rochelle Marie Wnuk, RDH
• Gregory Jay Wood
• Jamie Marie Wood, LMT, YTT
• Robert David Wood, CASAC ADVANCED
• Eileen Marie Woodcock I, PT, DPT
• Dawn Woodward, LMSW

• Speech-Language Pathologist in Utica, NY
• Providers in Utica, 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 Jul 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.