Individual provider Active NPI

Lauren J McIndoo, CCC-SLP, LIC

  • Speech-Language Pathologist
  • Syracuse, NY
National Provider Identifier
1194854109
Registry record updated Jul 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
008591-1 Issued in NY
Practice address
215 Bassett St
Syracuse, NY 13210-2113
Phone
(315) 472-4404
Fax
(315) 478-2337
NPI assigned
Mar 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2014

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 008591-1 NY Primary

Addresses

Primary practice location

215 Bassett St
Syracuse, NY 13210-2113

Mailing address

7502 Plum Hollow Cir
Liverpool, NY 13090-3625
Phone (315) 413-0080

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

State licenses

LicenseStateTypeSpecialty
008591-1NYMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Liberty Resources, Inc. Past Accepting new patients
Onondaga Pastoral Counseling Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lauren.mcindoo.p1@direct.liberty-resources.nextgenshare.com

Organizations & group practices 2

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": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404691200000",
    "number": "1194854109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7502 PLUM HOLLOW CIR",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130903625",
            "telephone_number": "315-413-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 BASSETT ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102113",
            "telephone_number": "315-472-4404",
            "fax_number": "315-478-2337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINDOO",
        "first_name": "LAUREN",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "CCC-SLP, LIC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2014-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "008591-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2014; 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.