Active NPI
Lisa Joan Williams, M.A.,CCC/SLP
- Speech-Language Pathologist
- Arnold, MO
National Provider Identifier
1255646683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 105176
- Practice address
- 4 Arnold Mall
Arnold, MO 63010-2223 - Phone
- (636) 282-0056
- NPI assigned
- Aug 10, 2010
- Last updated
- Aug 10, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 | 105176 | MO | Primary |
Addresses
Primary practice location
4 Arnold Mall
Arnold, MO 63010-2223
Mailing address
4 Arnold Mall
Arnold, MO 63010-2223
Phone (636) 282-0056
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 105176 | Other | MO | MISSOURI LICENSE NO. |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 105176 | MO | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281398400000",
"number": "1255646683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 ARNOLD MALL",
"city": "ARNOLD",
"state": "MO",
"postal_code": "630102223",
"telephone_number": "636-282-0056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 ARNOLD MALL",
"city": "ARNOLD",
"state": "MO",
"postal_code": "630102223",
"telephone_number": "636-282-0056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "LISA",
"middle_name": "JOAN",
"name_prefix": "Ms.",
"credential": "M.A.,CCC/SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-08-10",
"last_updated": "2010-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MO",
"license": "105176",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MISSOURI LICENSE NO.",
"identifier": "105176",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Arnold, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.