Lisa Marie Anderson, COTA/L
Individual provider Active NPI Occupational Therapy Assistant · Clarence, NY
NPI 1346889706 · NPPES record last updated Jan 3, 2020
Key facts
- NPI
- 1346889706
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 010249 (NY)
- Practice address
- 5269 Green Valley Dr
Clarence, NY 14031-1231 - Phone
- (716) 348-6294
- NPI assigned
- Jan 3, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010249 | NY | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 010249 | NY | Yes |
Addresses
Primary practice location
5269 Green Valley Dr
Clarence, NY 14031-1231
Mailing address
5269 Green Valley Dr
Clarence, NY 14031-1231
Phone (716) 348-6294
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010249 | Medicaid | NY |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | 010249 | Direct |
Other providers in Clarence, NY
- Abu Ali Sina Medical PLLC
- John Vincent Akiki
- Kristen M Alexander
- Allied Physicians of Buffalo, PC
- Beverly Amborski
- Erin C Andrade
- Patricia Ann Andzel
- Robert Richard Andzel
- Anthony Dee MD PLLC
- Timothy Edward Arent
All providers in Clarence, NY · Occupational Therapy Assistant in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 3, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.