WILLOW VIVIAN COPULOS
NPI 1679458657
Speech-Language Pathologist in Staten Island, NY

Q: What is Willow Copulos's NPI number?

The NPI number for Willow Copulos is 1679458657. It was assigned to this individual provider in the NPPES registry on August 8, 2025.

Q: What is Willow Copulos's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Q: When was this NPI record last updated?

The NPPES record for Willow Copulos was last updated on August 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 08, 2025

1415 RICHMOND AVE, STATEN ISLAND, NY 10314(877) 407-3422(877) 407-4329 Get Directions Write a Review

NPPES record last updated: August 8, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Willow Vivian Copulos NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WILLOW VIVIAN COPULOS (NPI 1679458657) is an individual speech-language pathologist provider in Staten Island, New York, licensed in New York (033852) and active in the NPI registry since August 2025. She is a graduate of Other (2022).

NPPES Registry Identity

NPI1679458657

Entity TypeIndividualFemale

Primary Taxonomy235Z00000X

Provider Legal NameWILLOW VIVIAN COPULOS

Location Address1415 RICHMOND AVEStaten Island, NY 10314-1553

Mailing Address7 Carnegie PlzCherry Hill, NJ 08003-1000 · (877) 407-3422 · Fax (877) 407-4329

Phone(877) 407-3422

Fax(877) 407-4329

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateAugust 8, 2025

NPPES CertifiedAugust 8, 2025

✔ NPI 1679458657 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers

Taxonomy Code235Z00000X

License✔ Licensed in NY · 033852

Definition

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

1415 RICHMOND AVE, Staten Island, NY 10314

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Willow Vivian Copulos is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8224537428

PECOS Enrollment IDI20250815001027

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