Provider Demographics
NPI:1548610280
Name:STONE, JESSI STEINBERG (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JESSI
Middle Name:STEINBERG
Last Name:STONE
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:JESSI
Other - Middle Name:ARIEL
Other - Last Name:STEINBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA CCC-SLP
Mailing Address - Street 1:SPRINGTIDE 35 COPPS HILL ROAD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877
Mailing Address - Country:US
Mailing Address - Phone:203-880-5495
Mailing Address - Fax:
Practice Address - Street 1:SPRINGTIDE 35 COPPS HILL ROAD
Practice Address - Street 2:SUITE 6
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877
Practice Address - Country:US
Practice Address - Phone:203-880-5495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-14
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9911235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist