Individual provider Active NPI

Lisa Sherbel, SLP

  • Speech-Language Pathologist
  • Bingham Farms, MI
National Provider Identifier
1417326059
Registry record updated Sep 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
5501016794 Issued in MI
Practice address
30100 Telegraph Road
Suite 140
Bingham Farms, MI 48025
Phone
(248) 385-0030
Fax
(248) 849-9980
NPI assigned
Sep 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 5501016794 MI Primary

Addresses

Primary practice location

30100 Telegraph Road
Suite 140
Bingham Farms, MI 48025

Mailing address

33900 Harper Ave
Suite 104
Clinton Township, MI 48035
Phone (586) 416-9100

Other names 1

  • Lisa Mervis Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501016794MIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1443052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443052800000",
    "number": "1417326059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE",
            "address_2": "SUITE 104",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "48035",
            "telephone_number": "586-416-9100",
            "fax_number": "586-416-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30100 TELEGRAPH ROAD",
            "address_2": "SUITE 140",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "48025",
            "telephone_number": "248-385-0030",
            "fax_number": "248-849-9980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERBEL",
        "first_name": "LISA",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-24",
        "last_updated": "2015-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "5501016794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "MERVIS",
            "credential": "SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bingham Farms, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2015; 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.