Laura Licuanan, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

8086 Issued in MA

Practice address

4 Militia Drive
Institute for Learning and Development
Lexington, MA 02421

Phone

(864) 230-0495

NPI assigned

Oct 7, 2011

Sex

Female

Sole proprietor

No

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": "1317945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317945600000",
    "number": "1265716245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 TRENTON ST",
            "address_2": "APT 1",
            "city": "EAST BOSTON",
            "state": "MA",
            "postal_code": "021282536",
            "telephone_number": "864-230-0495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MILITIA DRIVE",
            "address_2": "INSTITUTE FOR LEARNING AND DEVELOPMENT",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "02421",
            "telephone_number": "864-230-0495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICUANAN",
        "first_name": "LAURA",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-07",
        "last_updated": "2011-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "8086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philippa Li, MD
• Mei L Liang
• Olivia Liao, MD
• Karen Sophia Liazos
• Jane N Liberman, MS, CCC-A
• Fang-Tsuey Lin, LIC. AC.
• Li-Wei Lin, M.D.
• Joy Gila Nmi Lindsley, PH.D.
• Kevin M Linehan, LICSW
• Kimberly Linnell

• Speech-Language Pathologist in Lexington, MA
• Providers in Lexington, MA by specialty
• Speech-Language Pathologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; 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.