Individual provider Active NPI

Alyssa Laurenzi, M.A. CCC-SLP

  • Speech-Language Pathologist
  • Wickliffe, OH
National Provider Identifier
1205216447
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP.10969 Issued in OH
Practice address
28786 Alton Rd
Wickliffe, OH 44092-2512
Phone
(440) 278-0628
NPI assigned
Jun 3, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP.10969 OH Primary
Speech-Language Pathologist 235Z00000X

Addresses

Primary practice location

28786 Alton Rd
Wickliffe, OH 44092-2512

Mailing address

6700 Great Oaks Pkwy
Independence, OH 44131-4673
Phone (440) 278-0628

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.10969OHMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1433289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1205216447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 GREAT OAKS PKWY",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441314673",
            "telephone_number": "440-278-0628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28786 ALTON RD",
            "city": "WICKLIFFE",
            "state": "OH",
            "postal_code": "440922512",
            "telephone_number": "440-278-0628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAURENZI",
        "first_name": "ALYSSA",
        "name_prefix": "Miss",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-03",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.10969",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wickliffe, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; 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.