Active NPI
Lisa E Goulet, M.A., CCC-SLP
- Speech-Language Pathologist
- Sault Sainte Marie, MI
National Provider Identifier
1164992400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 7101002796
- Practice address
- 500 Osborn Blvd
Sault Sainte Marie, MI 49783-1884 - Phone
- (231) 250-1020
- NPI assigned
- Nov 29, 2018
- 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 | 7101002796 | MI | Primary |
Addresses
Primary practice location
500 Osborn Blvd
Sault Sainte Marie, MI 49783-1884
Mailing address
500 Osborn Blvd
Sault Sainte Marie, MI 49783-1884
Phone (906) 635-4426
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7101002796 | Other | MI | STATE OF MICHIGAN-DEPT. OF LICENSING AND REGULATORY AFFAIRS |
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 |
|---|---|---|---|
| 7101002796 | MI | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543449600000",
"number": "1164992400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 OSBORN BLVD",
"city": "SAULT SAINTE MARIE",
"state": "MI",
"postal_code": "497831884",
"telephone_number": "906-635-4426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 OSBORN BLVD",
"city": "SAULT SAINTE MARIE",
"state": "MI",
"postal_code": "497831884",
"telephone_number": "231-250-1020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOULET",
"first_name": "LISA",
"middle_name": "E",
"name_prefix": "Mrs.",
"credential": "M.A., CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-11-29",
"last_updated": "2018-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "MI",
"license": "7101002796",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF MICHIGAN-DEPT. OF LICENSING AND REGULATORY AFFAIRS",
"identifier": "7101002796",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sault Sainte Marie, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.