NPIMap

Organization Active NPI

Lakeshore Speech Therapy, LLC

  • Speech-Language Pathologist
  • Westlake, OH
National Provider Identifier
1285861369
Registry record updated Oct 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP4771 Issued in OH
Legal business name
LAKESHORE SPEECH THERAPY, LLC
Practice address
815 Crocker Rd
Suite #3
Westlake, OH 44145
Phone
(440) 471-7190
Fax
(480) 287-8108
NPI assigned
Jun 16, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2013

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

Authorized official

Name
Mrs. Tracy Anne Biller, MA CCC SLP
Title
Speech-Language Pathologist
Phone
(440) 471-7190

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 235Z00000X SP4771 OH Primary
Speech-Language PathologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 235Z00000X SP5229 OH

Addresses

Primary practice location

815 Crocker Rd
Suite #3
Westlake, OH 44145

Mailing address

815 Crocker Road
Suite #3
Westlake, OH 44145
Phone (440) 471-7190

National Provider Directory

National Provider Directory

Locations

815 Crocker Rd
Ste 3
Westlake, OH 44145
Phone (440) 471-7190

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381449600000",
    "number": "1285861369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 CROCKER ROAD",
            "address_2": "SUITE #3",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "44145",
            "telephone_number": "440-471-7190",
            "fax_number": "480-287-8108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 CROCKER RD",
            "address_2": "SUITE #3",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "44145",
            "telephone_number": "440-471-7190",
            "fax_number": "480-287-8108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE SPEECH THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-16",
        "last_updated": "2013-10-11",
        "status": "A",
        "authorized_official_last_name": "BILLER",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "440-471-7190",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA CCC SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP4771",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP5229",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2013; 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.