Individual provider Active NPI

Lynda Elizabeth Hanson, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Arnold, MO
National Provider Identifier
1104593649
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2020029604 Issued in MO
Practice address
3488 Jeffco Blvd Ste 102
Arnold, MO 63010-6015
Phone
(636) 464-5439
Fax
(636) 464-5438
NPI assigned
Aug 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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 2020029604 MO Primary

Addresses

Primary practice location

3488 Jeffco Blvd Ste 102
Arnold, MO 63010-6015

Mailing address

3488 Jeffco Blvd Ste 102
Arnold, MO 63010-6015
Phone (636) 464-5439

Other practice location 1

1812 Rock Rd
DE Soto, MO 63020-1048
Phone (636) 586-1040

Other practice location 2

4485 Sunrise School Rd
DE Soto, MO 63020-5140
Phone (636) 586-6660

Other names 1

  • Lyndi Elizabeth Hanson Other name

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 Science

State licenses

LicenseStateTypeSpecialty
2020029604MOMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise School District R-IX Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1104593649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3488 JEFFCO BLVD STE 102",
            "city": "ARNOLD",
            "state": "MO",
            "postal_code": "630106015",
            "telephone_number": "636-464-5439",
            "fax_number": "636-464-5438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3488 JEFFCO BLVD STE 102",
            "city": "ARNOLD",
            "state": "MO",
            "postal_code": "630106015",
            "telephone_number": "636-464-5439",
            "fax_number": "636-464-5438"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1812 Rock Rd",
            "address_purpose": "LOCATION",
            "city": "DE Soto",
            "state": "MO",
            "postal_code": "630201048",
            "country_code": "US",
            "telephone_number": "636-586-1040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4485 Sunrise School Rd",
            "address_purpose": "LOCATION",
            "city": "DE Soto",
            "state": "MO",
            "postal_code": "630205140",
            "country_code": "US",
            "telephone_number": "636-586-6660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANSON",
        "first_name": "LYNDA",
        "middle_name": "ELIZABETH",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-24",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2020029604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNDI",
            "last_name": "HANSON",
            "middle_name": "ELIZABETH",
            "credential": "M.S., CCC-SLP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Arnold, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.