Andrea Lacey

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

1162520 Issued in NJ

Practice address

17615 85TH Avenue CT E
Puyallup, WA 98375-1902

Phone

(253) 216-2589

NPI assigned

Oct 28, 2020

Last updated

Apr 12, 2024By 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

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Hona Medical Group PA

  dba Verse Therapy

  • Speech-Language Pathologist
  • Miami, FL
  • NPI 1487490553

  WA

  Medicare reassignment NPD
• Little Fin Therapies, LLC

  • Developmental Disabilities Clinic/Center
  • Puyallup, WA
  • NPI 1942811211
  NPD
• Speech Start, LLC

  • Speech-Language Pathologist
  • Fair Haven, NJ
  • NPI 1467098392
  NPD (past)
• Speech Start, LLC

  • Speech-Language Pathologist
  • Fair Haven, NJ
  • NPI 1679957997
  NPD (past)

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

{
    "created_epoch": "1603843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1174123202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17615 85TH AVENUE CT E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983751902",
            "telephone_number": "253-216-2589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17615 85TH AVENUE CT E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983751902",
            "telephone_number": "253-216-2589"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Bethany Rd Ste 60",
            "address_purpose": "LOCATION",
            "city": "Hazlet",
            "state": "NJ",
            "postal_code": "077301667",
            "country_code": "US",
            "telephone_number": "732-888-3912",
            "fax_number": "732-888-3916",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "120 E River Rd",
            "address_purpose": "LOCATION",
            "city": "Rumson",
            "state": "NJ",
            "postal_code": "077601631",
            "country_code": "US",
            "telephone_number": "732-888-3912",
            "fax_number": "732-888-3916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LACEY",
        "first_name": "ANDREA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-28",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "1162520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kzta
• L&T Chinese Medicine LLC
• L&T Chinese Medicine LLC (South Hill Acupuncture Clinic)
• Laboratory Corporation of America
• Laboratory Corporation of America
• Audrey Louise Lacey, PHARMACIST
• Ashley Lacy, LMFTA
• Denise Anne Ladenburg, ARNP
• Kristen Rene Ladenburg, RN
• Annemarie Ladlad

• Speech-Language Pathologist in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Speech-Language Pathologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.