Active NPI
Theresa Lackey
- Speech-Language Pathologist
- Stigler, OK
National Provider Identifier
1447601208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2470
- Practice address
- 309 NW E St
Stigler, OK 74462-1870 - Phone
- (918) 967-8875
- Fax
- (918) 967-5124
- NPI assigned
- Jun 23, 2016
- Last updated
- Jun 23, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 | 2470 | OK | Primary |
Addresses
Primary practice location
309 NW E St
Stigler, OK 74462-1870
Mailing address
309 NW E St
Stigler, OK 74462-1870
Phone (918) 967-8875
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 |
|---|---|---|---|
| 2470 | OK | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466640000000",
"number": "1447601208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "309 NW E ST",
"city": "STIGLER",
"state": "OK",
"postal_code": "744621870",
"telephone_number": "918-967-8875",
"fax_number": "918-967-5124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "309 NW E ST",
"city": "STIGLER",
"state": "OK",
"postal_code": "744621870",
"telephone_number": "918-967-8875",
"fax_number": "918-967-5124"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LACKEY",
"first_name": "THERESA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-23",
"last_updated": "2016-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OK",
"license": "2470",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stigler, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.