Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Vivian Black, CCCSLP

Individual provider Community Health Worker · NPI 1639629686

Vivian Black, CCCSLP is a Qualified Speech Language Pathologist in Saratoga Springs, New York. Qualified in 2021, 5 years ago. Practices as a sole proprietor and works from 2 locations. Licensed in New York.

Years since qualifying
5
Licensed in
NY
In the registry since
2016
Specialties on file
2

Practice location Address checks out

1 Blue Streak Blvd
Saratoga Springs, NY 12866-5952
Phone: (518) 587-6690
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 108 N Main St, Sunderland, MA 01375-9502 — (413) 665-8717

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 032067-01 (NY)
Community Health Worker Taxonomy 172V00000X

Record details

NPI number1639629686
Entity typeIndividual (Type 1)
GenderFemale
Credentials CCCSLP
Sole proprietorYes
NPI enumeratedOctober 13, 2016
Last updated in NPPESOctober 19, 2022
Certification dateOctober 19, 2022

Medicare enrollment

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

Medicare specialtyQUALIFIED SPEECH LANGUAGE PATHOLOGIST
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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