Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jessica Rae Eberhart, MSCCC-SLP

Individual provider Speech-Language Pathologist · NPI 1649819392

Jessica Rae Eberhart, MSCCC-SLP is a Qualified Speech Language Pathologist in Lake Ronkonkoma, New York. Qualified in 2018, 8 years ago. Practices with Expressable Therapy PC, a 63-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
8
Licensed in
NY
In the registry since
2019
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Practice location Address checks out

622 Hawkins Ave
Lake Ronkonkoma, NY 11779-2374
Phone: (631) 240-3579
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X (NY)

Record details

NPI number1649819392
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSCCC-SLP
Sole proprietorYes
NPI enumeratedDecember 29, 2019
Last updated in NPPESDecember 29, 2019
Certification dateDecember 29, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyQUALIFIED SPEECH LANGUAGE PATHOLOGIST
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Expressable Therapy Pc — 63 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Lake Ronkonkoma