Active NPI
Susan Lanzara Bean, SLP
- Speech-Language Pathologist
- Houghton, MI
National Provider Identifier
1568798122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1019
- Practice address
- 21987 Peepsock Rd
Houghton, MI 49931-1048 - Phone
- (603) 547-3311
- NPI assigned
- Nov 2, 2009
- Sex
- Female
- Sole proprietor
- No
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 | 1019 | NH | Primary |
Addresses
Primary practice location
21987 Peepsock Rd
Houghton, MI 49931-1048
Mailing address
21987 Peepsock Rd
Houghton, MI 49931-1048
Phone (603) 547-3311
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7101008644 | Other | MI | SLP LICENSE |
| 3076438 | Medicaid | NH | |
| SP1706 | Other | ME | SLP LICENSE |
| 1019 | Other | NH | SLP LICENSE |
Other names 1
- Susan Lanzara Fass
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 |
|---|---|---|---|
| 1019 | NH | MD | Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712620800000",
"number": "1568798122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21987 PEEPSOCK RD",
"city": "HOUGHTON",
"state": "MI",
"postal_code": "499311048",
"telephone_number": "603-547-3311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21987 PEEPSOCK RD",
"city": "HOUGHTON",
"state": "MI",
"postal_code": "499311048",
"telephone_number": "603-547-3311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAN",
"first_name": "SUSAN",
"middle_name": "LANZARA",
"name_prefix": "Mrs.",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-02",
"last_updated": "2024-04-09",
"certification_date": "2024-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NH",
"license": "1019",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SLP LICENSE",
"identifier": "7101008644",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3076438",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SLP LICENSE",
"identifier": "SP1706",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SLP LICENSE",
"identifier": "1019",
"state": "NH"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SUSAN",
"last_name": "FASS",
"middle_name": "LANZARA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Houghton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.