Provider Demographics
NPI:1578931143
Name:SCALESSE, STEPHANIE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:
Last Name:SCALESSE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:VERDINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:429 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:BAYPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11705-1330
Mailing Address - Country:US
Mailing Address - Phone:631-235-0450
Mailing Address - Fax:
Practice Address - Street 1:429 1ST AVE
Practice Address - Street 2:
Practice Address - City:BAYPORT
Practice Address - State:NY
Practice Address - Zip Code:11705-1330
Practice Address - Country:US
Practice Address - Phone:631-235-0450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-12
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026023235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist