Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Jacqueline Nicole Mortenson, MACCC-SLP

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1295214245

Mrs. Jacqueline Nicole Mortenson, MACCC-SLP is a Student in an Organized Health Care Education/Training Program in East Setauket, New York. Works from 2 locations. Licensed in New York.

Licensed in
NY
In the registry since
2018
Specialties on file
2
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Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

East Setauket, NY
Fax: (631) 331-6865

No coordinates on file. Search this address in Google Maps

Additional practice locations (1)

  • 222 E Middle Country Rd, Smithtown, NY 11787-2871 — (631) 525-7514

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 029121 (NY)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1295214245
Entity typeIndividual (Type 1)
GenderFemale
Credentials MACCC-SLP
Sole proprietorNo
NPI enumeratedAugust 10, 2018
Last updated in NPPESNovember 19, 2019

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