Stephanie Lynn De Sam Lazaro, OTRL

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

103343 Issued in MN

Practice address

900 W 94TH Street
The Therapy Place
Bloomington, MN 55420

Phone

(952) 885-0418

NPI assigned

Oct 20, 2006

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

Other names 1

• Ms. Stephanie Lynn Betts Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Family Achievement Center Inc.

  • Occupational Therapist
  • Woodbury, MN
  • NPI 1952411175
  NPD (past)
• The Therapy Place

  • Rehabilitation Clinic/Center
  • Bloomington, MN
  • NPI 1609934173
  NPD (past)

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619059169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 MONTREAL AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55116",
            "telephone_number": "651-699-5296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W 94TH STREET",
            "address_2": "THE THERAPY PLACE",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "55420",
            "telephone_number": "952-885-0418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE SAM LAZARO",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "103343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "BETTS",
            "middle_name": "LYNN",
            "prefix": "MS.",
            "credential": "OTRL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shelia Mae Davis
• Kafiya A. Dawi
• Melanie Day, MA, LPCC
• Khalid Dayib
• Jonathan Peter De Borst
• Katelynne Deal, PA-S
• Joshua Debritto
• Laura Katie Deering, OTR/L
• Ryan Edward Deering, PA-C
• Lauren Degn, PA-C

• Occupational Therapist in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.