Individual provider Active NPI

Stacey L Leachman, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Louisville, KY
National Provider Identifier
1497870125
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
KY2660 Issued in KY
Practice address
1209 Falcon Dr
Louisville, KY 40213-1217
Phone
(502) 876-2394
Fax
(502) 290-3638
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 KY2660 KY Primary

Addresses

Primary practice location

1209 Falcon Dr
Louisville, KY 40213-1217

Mailing address

1209 Falcon Dr
Louisville, KY 40213-1217
Phone (502) 876-2394

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
KY2660KYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497870125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 FALCON DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402131217",
            "telephone_number": "502-876-2394",
            "fax_number": "502-290-3638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 FALCON DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402131217",
            "telephone_number": "502-876-2394",
            "fax_number": "502-290-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEACHMAN",
        "first_name": "STACEY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": "KY2660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.