Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Phyllis R Penkethman, MS, CCC-SLP

Individual provider Speech-Language Pathologist · NPI 1083493381

Phyllis R Penkethman, MS, CCC-SLP is a Speech-Language Pathologist in Wall Township, New Jersey. Practices as a sole proprietor. Licensed in New Jersey.

Licensed in
NJ
In the registry since
2023
What do these letters mean?
MS — Master of Science
A graduate science 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

3349 Hwy 138
Wall Township, NJ 07719-9671
Phone: (732) 280-6050
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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 YS001121 (NJ)

Record details

NPI number1083493381
Entity typeIndividual (Type 1)
GenderFemale
Credentials MS , CCC-SLP
Sole proprietorYes
NPI enumeratedSeptember 26, 2023
Last updated in NPPESSeptember 26, 2023
Certification dateSeptember 26, 2023

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