Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1497065213 Individual Practitioner Female Practitioner

Stacy Sullivan , MA, CCC, LSP

Speech-Language Pathologist • Centerport, NY

Professional Overview & Biography Verified Profile Summary

Stacy Sullivan, MA, CCC, LSP is a registered healthcare professional specializing in Speech-Language Pathologist in Centerport, NY. Practice services are available at 235 JACKSON CRESCENT under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

235 Jackson Crescent

Centerport, NY 11721

Telephone 6314248972

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Centerport, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.0 Yrs
Regional Practice Density
11 Specialists

Practicing in Centerport, NY (25106 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License NY 0065631

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active October 14, 2010

NPI status registered as active in NPPES database

📍
Updated Practice Location October 14, 2010

Registered at 235 JACKSON CRESCENT, CENTERPORT, NY 11721 (Tel: 6314248972)

📍
Updated Business Mailing Address October 14, 2010

Registered at 235 JACKSON CRES, CENTERPORT, NY 117211054 (Tel: 6314248972)

👤
Provider Name / Credentials Updated October 14, 2010

Recorded as STACY SULLIVAN, MA,CCC/LSP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 14, 2010

Speech-Language Pathologist (License #0065631 in NY)

🟢
Initial NPI Registration & Enumeration October 14, 2010

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1497065213
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 14, 2010
Last Update: October 14, 2010
Sole Proprietor: Yes

Mailing Address

235 Jackson Cres

Centerport, NY 117211054

Phone: 6314248972

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.