Reagan F Lucas, MSCCC SLP

Individual provider Active NPI Speech-Language Pathologist · Riverside, OH

NPI 1124194899 · NPPES record last updated Feb 11, 2014

Key facts

NPI
1124194899
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SP 8378 (OH)
Practice address
801 Old Harshman Rd
Riverside, OH 45431-1238
Phone
(937) 237-4270
NPI assigned
Nov 27, 2006
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
SP 8378OHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mad River Local Schools Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP 8378 OH Yes

Addresses

Primary practice location

801 Old Harshman Rd
Riverside, OH 45431-1238

Mailing address

801 Old Harshman Rd
Riverside, OH 45431-1238
Phone (937) 237-4270

Other providers in Riverside, OH

All providers in Riverside, OH · Speech-Language Pathologist in Ohio

Sources for this page

Verify at the official NPI Registry.