Leslie Sudak, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

836 Issued in NH

Practice address

10 Mascoma St
Lebanon, NH 03766

Phone

(603) 867-0900

NPI assigned

Feb 8, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1202428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1235317512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 CHURCH ST UNIT 10",
            "city": "GOFFSTOWN",
            "state": "NH",
            "postal_code": "030458029",
            "telephone_number": "603-867-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MASCOMA ST",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "03766",
            "telephone_number": "603-867-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDAK",
        "first_name": "LESLIE",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-08",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "5675",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NH",
            "license": "836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tonya L Suarez, MSW
• Sara Subbanna, MD
• Lakshman Subrahmanyan, MD
• Melissa Lynne Suckling, OTR/L
• Bjoern Dominik Suckow, M.D.
• Stefanie Sueda
• Kali Jessica Sullivan
• Kayleigh Sullivan
• Sarah McBratney Sullivan, MD
• Shelby A Sullivan, MD

• Speech-Language Pathologist in Lebanon, NH
• Providers in Lebanon, NH by specialty
• Speech-Language Pathologist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2020; 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.