Individual provider Active NPI

Lauren Ann Mekilo, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Scranton, PA
National Provider Identifier
1508545567
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SL017071 Issued in PA
Practice address
2500 Adams Ave
Scranton, PA 18509-1515
Phone
(570) 343-4065
NPI assigned
Jul 17, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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 SL017071 PA Primary

Addresses

Primary practice location

2500 Adams Ave
Scranton, PA 18509-1515

Mailing address

2500 Adams Ave
Scranton, PA 18509-1515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240326000098 PA Practitioner - Qualified Speech Language Pathologist 4789021890 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SL017071PAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC Speech-Language Pathologist CurrentSince Feb 14, 2024 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Speech-Language Pathologist CurrentSince Feb 14, 2024 Accepting new patients
Cip Rehabilitation Inc CurrentSince Oct 6, 2025 Accepting new patients

Locations

64 Ridgway Dr
#1
Dallas, PA 18612
Phone (570) 255-4578

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1508545567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 ADAMS AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185091515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 ADAMS AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185091515",
            "telephone_number": "570-343-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEKILO",
        "first_name": "LAUREN",
        "middle_name": "ANN",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-17",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL017071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.