Individual provider Active NPI

Lisa M Mowry, M.A. CCC

  • Speech-Language Pathologist
  • West Hartford, CT
National Provider Identifier
1205953148
Registry record updated Sep 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
001725 Issued in CT
Practice address
1 Abrahms Blvd
West Hartford, CT 06117-1508
Phone
(860) 523-3860
Fax
(860) 523-3819
NPI assigned
Mar 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2011

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 001725 CT Primary

Addresses

Primary practice location

1 Abrahms Blvd
West Hartford, CT 06117-1508

Mailing address

200 Norton Rd
Kensington, CT 06037-2922

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

NPI Registry JSON

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

{
    "created_epoch": "1174694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315353600000",
    "number": "1205953148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NORTON RD",
            "city": "KENSINGTON",
            "state": "CT",
            "postal_code": "060372922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ABRAHMS BLVD",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061171508",
            "telephone_number": "860-523-3860",
            "fax_number": "860-523-3819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOWRY",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "M.A. CCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-24",
        "last_updated": "2011-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CT",
            "license": "001725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2011; 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.