Individual ProviderJendayi Lauvenia JohnsonSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address1415 Richmond Ave, Staten Island, NY 10314-1553(877) 407-3422PECOS EnrollmentBased on the most recent information from CMS, provider Jendayi Lauvenia Johnson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1376105619Provider TypeIndividualFull NameJohnson, Jendayi LauveniaGenderFemaleSole ProprietorNoEnumeration Date7/8/2019Last Updated7/8/2019Contact InformationPractice LocationPractice Address1415 Richmond Ave, Staten Island, NY 10314-1553Phone(877) 407-3422Fax(877) 407-4329Mailing LocationMailing Address7 Carnegie Plz, Cherry Hill, NJ 08003-1000Phone(877) 407-3422Fax(877) 407-4329Provider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicenseUnlisted Issuer