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

Individual provider Speech-Language Pathologist · NPI 1104486620

Stephanie Moulketis, MS, CCC-SLP is a Speech-Language Pathologist in Staten Island, New York. Works from 2 locations. Licensed in New York.

Licensed in
NY
In the registry since
2019
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

88 Old Town Rd
Staten Island, NY 10304-4212
Phone: (718) 407-2911
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 330 Saint Marks Pl, Staten Island, NY 10301-2409 — (201) 741-6960

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 027806 (NY)

Record details

NPI number1104486620
Entity typeIndividual (Type 1)
GenderFemale
Credentials MS , CCC-SLP
Sole proprietorNo
NPI enumeratedJune 17, 2019
Last updated in NPPESJune 17, 2019

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