Active NPI
Stevenson Prussner, CCC-SLP
- Speech-Language Pathologist
- Muskegon, MI
National Provider Identifier
1992410567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 7101008648
- Practice address
- 1910 E Apple Ave Ste GH
Muskegon, MI 49442-4281 - Phone
- (231) 333-9148
- NPI assigned
- Jan 18, 2023
- 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 | 7101008648 | MI | Primary |
Addresses
Primary practice location
1910 E Apple Ave Ste GH
Muskegon, MI 49442-4281
Mailing address
1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224
Phone (142) 944-0509
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7101008648 | MI | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698105600000",
"number": "1992410567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1311 MAMARONECK AVE STE 140",
"city": "WHITE PLAINS",
"state": "NY",
"postal_code": "106055224",
"telephone_number": "142-944-0509"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1910 E APPLE AVE STE GH",
"city": "MUSKEGON",
"state": "MI",
"postal_code": "494424281",
"telephone_number": "231-333-9148"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRUSSNER",
"first_name": "STEVENSON",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-01-18",
"last_updated": "2023-10-24",
"certification_date": "2023-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MI",
"license": "7101008648",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Muskegon, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.