Healthcare Provider Details

I. General information

NPI: 1972929388
Provider Name (Legal Business Name): KATELYN ALLISON POWELL M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2014
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53 GIBSON RD
GOSHEN NY
10924-6709
US

IV. Provider business mailing address

18 UNION ST
CORNWALL NY
12518-1619
US

V. Phone/Fax

Practice location:
  • Phone: 845-291-0100
  • Fax: 845-291-0129
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number029481-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: