Alexandra Rae Lertola, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

22007598A Issued in IN

Practice address

53940 Carmichael Dr
South Bend, IN 46635-1564

Phone

(574) 335-6212

Fax

(574) 335-0809

NPI assigned

Sep 16, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1600214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1467068403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53940 CARMICHAEL DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351564",
            "telephone_number": "574-335-6212",
            "fax_number": "574-335-0809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53940 CARMICHAEL DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351564",
            "telephone_number": "574-335-6212",
            "fax_number": "574-335-0809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LERTOLA",
        "first_name": "ALEXANDRA",
        "middle_name": "RAE",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-16",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22007598A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia J Lemp, LCSW
• Jeff Lemp, LSW
• Jonah Lenters, PHARMD
• Melissa A Lentine, LSW
• Paul Leonard, MSW
• Karen Louise Lesch, N.P.
• Neil K Lesh, M.D.
• Edward Lester Jr.
• Justin Leugers, MD
• Melanie Lillian Leveille, DO

• Speech-Language Pathologist in South Bend, IN
• Providers in South Bend, IN by specialty
• Speech-Language Pathologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.