Active NPI
Lyn Dee Harrelson, CCC-SLP
- Speech-Language Pathologist
- North Hills, CA
National Provider Identifier
1053802686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 14398
- Practice address
- 16457 Gledhill St
North Hills, CA 91343-2845 - Phone
- (818) 808-9809
- NPI assigned
- May 18, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP10763 | AZ | |
| Speech-Language Pathologist | 235Z00000X | 14398 | CA | Primary |
Addresses
Primary practice location
16457 Gledhill St
North Hills, CA 91343-2845
Mailing address
16457 Gledhill St
North Hills, CA 91343-2845
Phone (818) 808-9809
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12064444 | Other | AMERICAN SPEECH-LANGUAGE HEARING ASSOCIATION LICENSE # | |
| 14398 | Other | CA | LICENSE TO PRACTICE SPEECH LANGUAGE PATHOLOGY |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP10763 | AZ | MD | Speech-Language Pathologist |
| 14398 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526601600000",
"number": "1053802686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16457 GLEDHILL ST",
"city": "NORTH HILLS",
"state": "CA",
"postal_code": "913432845",
"telephone_number": "818-808-9809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16457 GLEDHILL ST",
"city": "NORTH HILLS",
"state": "CA",
"postal_code": "913432845",
"telephone_number": "818-808-9809"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRELSON",
"first_name": "LYN",
"middle_name": "DEE",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-18",
"last_updated": "2018-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AZ",
"license": "SLP10763",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "14398",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN SPEECH-LANGUAGE HEARING ASSOCIATION LICENSE #",
"identifier": "12064444",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE TO PRACTICE SPEECH LANGUAGE PATHOLOGY",
"identifier": "14398",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 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.