Provider Demographics
| NPI: | 1184847261 |
|---|---|
| Name: | COMMUNICATION CENTER FOR HEARING AND SPEECH |
| Entity Type: | Organization |
| Organization Name: | COMMUNICATION CENTER FOR HEARING AND SPEECH |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | DIRECTOR |
| Authorized Official - Prefix: | MRS |
| Authorized Official - First Name: | KENDRA |
| Authorized Official - Middle Name: | L |
| Authorized Official - Last Name: | MARASCO |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 585-223-5090 |
| Mailing Address - Street 1: | 6800 PITTSFORD PALMYRA RD |
| Mailing Address - Street 2: | SUITE 320 |
| Mailing Address - City: | FAIRPORT |
| Mailing Address - State: | NY |
| Mailing Address - Zip Code: | 14450-3584 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 585-223-5090 |
| Mailing Address - Fax: | 585-223-5589 |
| Practice Address - Street 1: | 6800 PITTSFORD PALMYRA RD |
| Practice Address - Street 2: | SUITE 320 |
| Practice Address - City: | FAIRPORT |
| Practice Address - State: | NY |
| Practice Address - Zip Code: | 14450-3584 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 585-223-5090 |
| Practice Address - Fax: | 585-223-5589 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2007-04-10 |
| Last Update Date: | 2010-08-18 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| NY | 103T00000X, 104100000X, 2251P0200X, 225XP0200X, 231H00000X, 231HA2400X, 231HA2500X, 235Z00000X, 237600000X, 252Y00000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty | |
| No | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | Group - Multi-Specialty | |
| No | 104100000X | Behavioral Health & Social Service Providers | Social Worker | Group - Multi-Specialty | |
| No | 2251P0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics | Group - Multi-Specialty |
| No | 225XP0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics | Group - Multi-Specialty |
| No | 231H00000X | Speech, Language and Hearing Service Providers | Audiologist | Group - Multi-Specialty | |
| No | 231HA2400X | Speech, Language and Hearing Service Providers | Audiologist | Assistive Technology Practitioner | Group - Multi-Specialty |
| No | 231HA2500X | Speech, Language and Hearing Service Providers | Audiologist | Assistive Technology Supplier | Group - Multi-Specialty |
| No | 237600000X | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter | Group - Multi-Specialty | |
| No | 252Y00000X | Agencies | Early Intervention Provider Agency | Group - Multi-Specialty |
