Active NPI
Lisa Susan Prazak, SLP
- Speech-Language Pathologist
- Centralia, WA
National Provider Identifier
1356687800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- LL60280882
- Practice address
- 1820 Cooks Hill Rd
Centralia, WA 98531 - Phone
- (360) 330-8720
- Fax
- (360) 330-8737
- NPI assigned
- Jan 2, 2013
- Sex
- Female
- Sole proprietor
- No
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 | LL60280882 | WA | Primary |
Addresses
Primary practice location
1820 Cooks Hill Rd
Centralia, WA 98531
Mailing address
914 S. Scheuber Rd
Rehab Therapies
Centralia, WA 98531
Phone (360) 330-8720
Other names 1
- Lisa Susan Hofheimer
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL60280882 | WA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357084800000",
"number": "1356687800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "914 S. SCHEUBER RD",
"address_2": "REHAB THERAPIES",
"city": "CENTRALIA",
"state": "WA",
"postal_code": "98531",
"telephone_number": "360-330-8720",
"fax_number": "360-330-8737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1820 COOKS HILL RD",
"city": "CENTRALIA",
"state": "WA",
"postal_code": "98531",
"telephone_number": "360-330-8720",
"fax_number": "360-330-8737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRAZAK",
"first_name": "LISA",
"middle_name": "SUSAN",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-02",
"last_updated": "2013-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WA",
"license": "LL60280882",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LISA",
"last_name": "HOFHEIMER",
"middle_name": "SUSAN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Centralia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.