Lisa Renee Kirby, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

06541 Issued in MD

Practice address

14201 School LN
Upper Marlboro, MD 20772-2866

Phone

(301) 952-6000

NPI assigned

Dec 6, 2018

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1544054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544054400000",
    "number": "1225509953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 LONDON PLANE CT",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206033969",
            "telephone_number": "301-396-4511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14201 SCHOOL LN",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207722866",
            "telephone_number": "301-952-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRBY",
        "first_name": "LISA",
        "middle_name": "RENEE",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-06",
        "last_updated": "2018-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "06541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Upper Marlboro, MD
• Providers in Upper Marlboro, MD by specialty
• Speech-Language Pathologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.