Individual provider Active NPI

Lauren J Clark, M.S.

  • Speech-Language Pathologist
  • Buffalo, NY
National Provider Identifier
1265669741
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
N/A
Practice address
51 St Johns Parkside
Buffalo, NY 14210-2515
Phone
(716) 828-9560
Fax
(716) 828-9460
NPI assigned
Jun 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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 N/A Primary

Addresses

Primary practice location

51 St Johns Parkside
Buffalo, NY 14210-2515

Mailing address

1895 N Creek Rd
Lake View, NY 14085-9507
Phone (716) 864-1687

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211001000663 NY Practitioner - Qualified Speech Language Pathologist 1254739451 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
020119NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Presence Sealy Counseling and Development Licensedclinicalservicespllc CurrentSince Sep 25, 2021 Accepting new patients
Presence Psychology, LMSW, PT, OT and SLP Services, PLLC Speech-Language Pathologist CurrentSince Sep 25, 2021 Accepting new patients
Baker Hall Inc Past Accepting new patients

Locations

115 Fall St
Seneca Falls, NY 13148
Phone (315) 515-5183

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1244678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1265669741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1895 N CREEK RD",
            "city": "LAKE VIEW",
            "state": "NY",
            "postal_code": "140859507",
            "telephone_number": "716-864-1687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 ST JOHNS PARKSIDE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142102515",
            "telephone_number": "716-828-9560",
            "fax_number": "716-828-9460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "LAUREN",
        "middle_name": "J",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-11",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": "N/A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.