Active NPI
Meghan Lake, M.S., CCC-SLP
- Speech-Language Pathologist
- Los Angeles, CA
National Provider Identifier
1033617188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 17409
- Practice address
- 11605 Washington PL
Los Angeles, CA 90066-5013 - Phone
- (310) 337-7115
- NPI assigned
- Jan 23, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 17409 | CA | Primary |
Addresses
Primary practice location
11605 Washington PL
Los Angeles, CA 90066-5013
Mailing address
11605 Washington PL
Los Angeles, CA 90066-5013
Phone (310) 337-7155
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17409 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapy West, Inc | Speech-Language Pathologist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516665600000",
"number": "1033617188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11605 WASHINGTON PL",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900665013",
"telephone_number": "310-337-7155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11605 WASHINGTON PL",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900665013",
"telephone_number": "310-337-7115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAKE",
"first_name": "MEGHAN",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-01-23",
"last_updated": "2018-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "17409",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.