Active NPI
Lisa Marie Moran, MS, CCC-SLP
- Speech-Language Pathologist
- Medford, MA
National Provider Identifier
1235262015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 6999
- Practice address
- 200 Governors Ave
Medford, MA 02155-1644 - Phone
- (781) 391-5400
- NPI assigned
- Mar 13, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 6999 | MA | Primary |
Addresses
Primary practice location
200 Governors Ave
Medford, MA 02155-1644
Mailing address
233 Park St
North Reading, MA 01864-3230
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6999 | MA | MD | Veterinarian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390348800000",
"number": "1235262015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "233 PARK ST",
"city": "NORTH READING",
"state": "MA",
"postal_code": "018643230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 GOVERNORS AVE",
"city": "MEDFORD",
"state": "MA",
"postal_code": "021551644",
"telephone_number": "781-391-5400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORAN",
"first_name": "LISA",
"middle_name": "MARIE",
"credential": "MS, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-13",
"last_updated": "2014-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MA",
"license": "6999",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.