Active NPI
Lisa A Harrison, M.S.CCC;SLP
- Speech-Language Pathologist
- Rochester, NY
National Provider Identifier
1629162680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 015252-1
- Practice address
- 965 N Goodman St
Rochester, NY 14609-3930 - Phone
- (585) 350-9888
- Fax
- (585) 288-3654
- NPI assigned
- Oct 3, 2006
- Last updated
- Jan 12, 2012
- 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 | 015252-1 | NY | Primary |
Addresses
Primary practice location
965 N Goodman St
Rochester, NY 14609-3930
Mailing address
216 Judson St
Rochester, NY 14580
Phone (585) 350-9888
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30-0213081 | Other | NY | TAX ID |
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 |
|---|---|---|---|
| 015252-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326326400000",
"number": "1629162680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "216 JUDSON ST",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "14580",
"telephone_number": "585-350-9888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "965 N GOODMAN ST",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146093930",
"telephone_number": "585-350-9888",
"fax_number": "585-288-3654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRISON",
"first_name": "LISA",
"middle_name": "A",
"name_prefix": "Mrs.",
"credential": "M.S.CCC;SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-03",
"last_updated": "2012-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "015252-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "30-0213081",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.