Individual provider Active NPI

Lauren Elizabeth Goodman, M.A. CCC/SLP

  • Speech-Language Pathologist
  • Shaker Heights, OH
National Provider Identifier
1205090149
Registry record updated Sep 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP.11200 Issued in OH
Practice address
15600 Parkland Dr
Shaker Heights, OH 44120-2529
Phone
(216) 295-4150
NPI assigned
Jul 10, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X SP.11200 OH Primary

Addresses

Primary practice location

15600 Parkland Dr
Shaker Heights, OH 44120-2529

Mailing address

5560 Lansbury LN
Lyndhurst, OH 44124-3818
Phone (440) 479-4815

Other practice location 1

2425 W Pratt Blvd
Chicago, IL 60645-4665
Phone (773) 353-5437

Other practice location 2

15400 S Woodland Rd
Shaker Heights, OH 44120-1850
Phone (216) 295-4150 ext. 4985

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

LicenseStateTypeSpecialty
SP.11200OHMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1205090149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5560 LANSBURY LN",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441243818",
            "telephone_number": "440-479-4815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15600 PARKLAND DR",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441202529",
            "telephone_number": "216-295-4150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2425 W Pratt Blvd",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606454665",
            "country_code": "US",
            "telephone_number": "773-353-5437",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15400 S Woodland Rd",
            "address_purpose": "LOCATION",
            "city": "Shaker Heights",
            "state": "OH",
            "postal_code": "441201850",
            "country_code": "US",
            "telephone_number": "216-295-4150 x4985",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "LAUREN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "M.A. CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-10",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.11200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shaker Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.

Verify at the official NPI Registry.