Individual provider Active NPI

Lauren Srock, SLPA

  • Speech-Language Assistant
  • Phoenix, AZ
National Provider Identifier
1063936862
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
9486 Issued in AZ
Practice address
7402 W Catalina Dr
Phoenix, AZ 85033-5502
Phone
(602) 764-1100
NPI assigned
Aug 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 9486 AZ Primary

Addresses

Primary practice location

7402 W Catalina Dr
Phoenix, AZ 85033-5502

Mailing address

4731 W Villa Theresa Dr
Glendale, AZ 85308-1446
Phone (928) 890-7718

Other practice location 1

3839 W Camelback Rd
Phoenix, AZ 85019-2512
Phone (602) 764-6022

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

LicenseStateTypeSpecialty
9486AZMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1501632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1063936862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4731 W VILLA THERESA DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081446",
            "telephone_number": "928-890-7718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7402 W CATALINA DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850335502",
            "telephone_number": "602-764-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3839 W Camelback Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850192512",
            "country_code": "US",
            "telephone_number": "602-764-6022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SROCK",
        "first_name": "LAUREN",
        "credential": "SLPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-02",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "AZ",
            "license": "9486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.

Verify at the official NPI Registry.