Active NPI
Lisa Nudelman, M.A., CCC-SLP
- Speech-Language Pathologist
- Centerburg, OH
National Provider Identifier
1104249614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP. 10540
- Practice address
- 207 S Preston St
Centerburg, OH 43011-8021 - Phone
- (740) 625-6488
- NPI assigned
- Feb 4, 2014
- 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 | SP. 10540 | OH | Primary |
Addresses
Primary practice location
207 S Preston St
Centerburg, OH 43011-8021
Mailing address
5083 Locust Post LN
Columbus, OH 43230-4500
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP. 10540 | OH | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1391472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1499817600000",
"number": "1104249614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5083 LOCUST POST LN",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432304500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 S PRESTON ST",
"city": "CENTERBURG",
"state": "OH",
"postal_code": "430118021",
"telephone_number": "740-625-6488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NUDELMAN",
"first_name": "LISA",
"credential": "M.A., CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-02-04",
"last_updated": "2017-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OH",
"license": "SP. 10540",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Centerburg, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.