Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Keely Anne Lavelle, MA, CCC-SLP

Individual provider Speech-Language Pathologist · NPI 1164814943

Keely Anne Lavelle, MA, CCC-SLP is a Qualified Speech Language Pathologist in Staten Island, New York. Qualified in 2012, 14 years ago. Practices as a sole proprietor. Licensed in New Jersey and New York.

Years since qualifying
14
Licensed in
NJ, NY
In the registry since
2015
Specialties on file
2
What do these letters mean?
MA — Master of Arts
A graduate arts degree.
CCC-SLP — Certificate of Clinical Competence in Speech-Language Pathology
A speech-language pathologist certified by ASHA.

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Practice location Address checks out

285 Edison St
Staten Island, NY 10306-3156
Phone: (718) 619-6093
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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 · Licence 023053 (NY)
Speech-Language Pathologist Taxonomy 235Z00000X · Licence 41YS00732200 (NJ)

Record details

NPI number1164814943
Entity typeIndividual (Type 1)
GenderFemale
Credentials MA , CCC-SLP
Sole proprietorYes
NPI enumeratedMarch 3, 2015
Last updated in NPPESMarch 3, 2015

Medicare enrollment

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

Medicare specialtyQUALIFIED SPEECH LANGUAGE PATHOLOGIST
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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