Individual provider Active NPI

Pauline Lilley-Harvey

  • Speech-Language Pathologist
  • Port Saint Lucie, FL
National Provider Identifier
1063611424
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA6278 Issued in NY
Practice address
2398 SW Indigo LN
Port Saint Lucie, FL 34953-2158
Phone
(772) 336-7587
Fax
(772) 343-7676
NPI assigned
Jul 16, 2007
Last updated
Jul 16, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SA6278 NY Primary

Addresses

Primary practice location

2398 SW Indigo LN
Port Saint Lucie, FL 34953-2158

Mailing address

2398 SW Indigo LN
Port Saint Lucie, FL 34953-2158
Phone (772) 336-7587

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260109001997 FL Practitioner - Qualified Speech Language Pathologist 3173009032 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1988
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1515 Snapdragon Dr
Wellington, FL 33414-8678

234 Mall Blvd
Suite G50
King of Prussia, PA 19406-2921

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SA6278NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Inhometherapy Inc Speech-Language Pathologist CurrentSince Jan 1, 2026 Accepting new patients
Pediatric Mobility, Inc Past Accepting new patients

Locations

6141 Lake Worth Rd
Greenacres, FL 33463
Phone (561) 963-4577

234 Mall Blvd
Ste G50
King of Prussia, PA 19406
Phone (610) 379-2852

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1063611424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2398 SW INDIGO LN",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349532158",
            "telephone_number": "772-336-7587",
            "fax_number": "772-343-7676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2398 SW INDIGO LN",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349532158",
            "telephone_number": "772-336-7587",
            "fax_number": "772-343-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLEY-HARVEY",
        "first_name": "PAULINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-16",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "SA6278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.