Individual provider Active NPI

Kathleen M. Lord, M.S., CCC/SLP

  • Speech-Language Pathologist
  • Brookfield, CT
National Provider Identifier
1417145681
Registry record updated Oct 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
001597 Issued in CT
Practice address
246 Federal Rd
Suite D-22
Brookfield, CT 06804-2647
Phone
(203) 775-5777
Fax
(203) 775-6890
NPI assigned
Oct 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 001597 CT Primary
Speech-Language Pathologist 235Z00000X 003570-1 NY

Addresses

Primary practice location

246 Federal Rd
Suite D-22
Brookfield, CT 06804-2647

Mailing address

246 Federal Rd
Suite D-22
Brookfield, CT 06804-2647
Phone (203) 775-5777

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
001597CTMDOptician
003570-1NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1192147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192147200000",
    "number": "1417145681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 FEDERAL RD",
            "address_2": "SUITE D-22",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068042647",
            "telephone_number": "203-775-5777",
            "fax_number": "203-775-6890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 FEDERAL RD",
            "address_2": "SUITE D-22",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068042647",
            "telephone_number": "203-775-5777",
            "fax_number": "203-775-6890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORD",
        "first_name": "KATHLEEN",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "M.S., CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-12",
        "last_updated": "2007-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CT",
            "license": "001597",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "003570-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2007; 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.