Lisa Marie Coulter, MS-CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

9-154 Issued in WI

Practice address

115 E Arndt St
Fond Du Lac, WI 54935-2461

Phone

(920) 923-7054

Fax

(920) 923-7058

NPI assigned

May 4, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lisa Marie Balmer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Taylored Rehab, LLC

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  • Fond Du Lac, WI
  • NPI 1356485791

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083826838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94",
            "city": "BROWNSVILLE",
            "state": "WI",
            "postal_code": "530060094",
            "telephone_number": "920-583-3923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E ARNDT ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549352461",
            "telephone_number": "920-923-7054",
            "fax_number": "920-923-7058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULTER",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MS-CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "9-154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42714000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "BALMER",
            "middle_name": "MARIE",
            "credential": "MS-CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Corbett Chiropractic Care, SC
• Deborah Leah Chagnon Corbett, D.C.
• Vicki D Corcoran, PTA
• Cornerstone Caregiving East LLC
• Elizabeth M Cotter, RN
• Carol A Craig, CRNA
• Emily Crego
• Mary Lee Crook, LPN
• Crossroads Care Center of Fond Du Lac LLC (Avina of Fond du Lac)
• Courtnee Crull

• Speech-Language Pathologist in Fond Du Lac, WI
• Providers in Fond Du Lac, WI by specialty
• Speech-Language Pathologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.