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

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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