Individual provider Active NPI

Sara Lipson, M.S., CCC-SLP

  • Speech-Language Pathologist
  • West Bloomfield, MI
National Provider Identifier
1629512488
Registry record updated Aug 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101001418 Issued in MI
Practice address
2981 Bloomfield Park Dr
West Bloomfield, MI 48323-3508
Phone
(248) 910-1373
NPI assigned
Dec 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 7101001418 MI Primary

Addresses

Primary practice location

2981 Bloomfield Park Dr
West Bloomfield, MI 48323-3508

Mailing address

2981 Bloomfield Park Dr
West Bloomfield, MI 48323-3508
Phone (248) 910-1373

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
7101001418MIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psygenics Inc Speech-Language Pathologist PastSince Jan 1, 2017 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1481587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598140800000",
    "number": "1629512488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2981 BLOOMFIELD PARK DR",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483233508",
            "telephone_number": "248-910-1373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2981 BLOOMFIELD PARK DR",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483233508",
            "telephone_number": "248-910-1373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPSON",
        "first_name": "SARA",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-13",
        "last_updated": "2020-08-23",
        "certification_date": "2020-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101001418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2020; 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.