Lauren E Illencik, ORT/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

0119008159 Issued in VA

Practice address

5301 Providence Rd Ste 80And90
Virginia Beach, VA 23464-4128

Phone

(757) 467-4604

Fax

(757) 467-2716

NPI assigned

Apr 6, 2021

Last updated

Apr 28, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Northern Arizona Healthcare Corporation

  • Family Medicine Physician
  • Flagstaff, AZ
  • NPI 1669914552
  Medicare reassignment NPD
• Creating Possibilots Therapy Services

  • Occupational Therapist
  • Yorktown, VA
  • NPI 1659177293
  NPD Authorized official
• Northern Arizona Healthcare Corporation

  dba Northern Arizona Healthcare Children's Health Center

  • Multi-Specialty Clinic/Center
  • Flagstaff, AZ
  • NPI 1235732702
  NPD

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1366021354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1377 MOTOR PKWY STE 307",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117495258",
            "telephone_number": "914-294-4050",
            "fax_number": "631-760-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 PROVIDENCE RD STE 80AND90",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234644128",
            "telephone_number": "757-467-4604",
            "fax_number": "757-467-2716"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5130 N US Highway 89",
            "address_purpose": "LOCATION",
            "city": "Flagstaff",
            "state": "AZ",
            "postal_code": "860042837",
            "country_code": "US",
            "telephone_number": "928-773-2054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ILLENCIK",
        "first_name": "LAUREN",
        "middle_name": "E",
        "credential": "ORT/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-06",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119008159",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "009314",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iheart's Care LLC
• Ihotu LLC
• Caiden Ijames
• Tanya Petrova Ilieva
• Vladimir Alexander Ilin, MD
• Jeffrey Joseph Illinik, PHYSICIAN ASSISTANT
• Illumination, LLC (Lotus Acupuncture and Holistic Health Clinic)
• Impact Counseling, Coaching & Consulting LLC
• Kavita D Imrit-Thomas, DO
• In Good Hands Chiropractic PC

• Occupational Therapist in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Occupational Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; 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.