Olivia R Lust, MA CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP2940 Issued in ME

Practice address

516 Mount Hope Ave
Bangor, ME 04401-4215

Phone

(947) 613-1207

NPI assigned

Aug 15, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1558841981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 MAIN RD N",
            "city": "HAMPDEN",
            "state": "ME",
            "postal_code": "044441802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 MOUNT HOPE AVE",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014215",
            "telephone_number": "947-613-1207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUST",
        "first_name": "OLIVIA",
        "middle_name": "R",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-15",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "ME",
            "license": "ST2829",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ME",
            "license": "SP2940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan J Lufkin-Curtis, MSN, FNP-C, CNM
• Rachel Ann Lukas, DMD
• Bryan J Lundquist, MD
• Lisa Lunn
• Flavian Mark Lupinetti, M.D.
• Algernon Leo Lutwak, MD
• Kaydence Lux, CCMA
• Luxottica of America Inc.
• Galina Lvin, W.H.C.N.P.
• Denise Lyakhovich

• Speech-Language Pathologist in Bangor, ME
• Providers in Bangor, ME by specialty
• Speech-Language Pathologist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; 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.