Lisa Larson

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

41YS00882400 Issued in NJ

Practice address

535 Mountain Ave
New Providence, NJ 07974-2002

Phone

(908) 295-5608

NPI assigned

Apr 29, 2017

Sex

Female

Sole proprietor

No

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)

Enrolled

State licenses

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

{
    "created_epoch": "1493424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497398400000",
    "number": "1609301407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 WHITNEY DR",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 MOUNTAIN AVE",
            "city": "NEW PROVIDENCE",
            "state": "NJ",
            "postal_code": "079742002",
            "telephone_number": "908-295-5608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "LISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-29",
        "last_updated": "2017-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00882400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meredith Miller Kowalczyk, PT, DPT
• Karla Mia Kristo, PHARMD
• Kwenyan Professional Health Services, LLC
• Kevin Joseph Lake, DMD
• Lantern Hill, Inc.
• Brooke Laster
• Jeffrey T Leary, MD
• Terrence Hone-Chung Lee, M.D.
• Janet Leicht, DPM
• Todd Owen Leventhal, M.D.

• Speech-Language Pathologist in New Providence, NJ
• Providers in New Providence, NJ by specialty
• Speech-Language Pathologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2017; 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.