Lydia Mischa Lacy, MA.CCC.SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP008693 Issued in GA

Practice address

342 McCook Cir NW
Kennesaw, GA 30144-3157

Phone

(810) 499-2767

NPI assigned

Mar 8, 2018

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

Practice roles

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.

• Katalyst Speech Therapy

  • Speech-Language Pathologist
  • Kennesaw, GA
  • NPI 1003743634
  NPD Authorized official

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

{
    "created_epoch": "1520467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1578065280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 MCCOOK CIR NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301443157",
            "telephone_number": "810-499-2767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 MCCOOK CIR NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301443157",
            "telephone_number": "810-499-2767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACY",
        "first_name": "LYDIA",
        "middle_name": "MISCHA",
        "credential": "MA.CCC.SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-08",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP008693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel John Kuzio, M.D.
• Valeria Labastida Torres
• Labor of Love Total Care, Inc
• Brian Labruzzo
• Kelly Lacy
• Torie Danielle Ladendorf
• Lake Pointe Wellness Center
• Christopher Laldin
• Tiffany Marie Lamas, DSW, LCSW
• Lamplight Counseling

• Speech-Language Pathologist in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; 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.