Active NPI
Teresa Dawn Lee, M.S. CCC-SP
- Speech-Language Pathologist
- Mitchell, IN
National Provider Identifier
1639344633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 22001291A
- Practice address
- 1125 Dixie Hwy
Mitchell, IN 47446-6737 - Phone
- (812) 583-6414
- Fax
- (812) 849-5225
- NPI assigned
- Apr 30, 2008
- Last updated
- Apr 30, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 | 22001291A | IN | Primary |
Addresses
Primary practice location
1125 Dixie Hwy
Mitchell, IN 47446-6737
Mailing address
1125 Dixie Hwy
Mitchell, IN 47446-6737
Phone (812) 583-6414
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00211144 | Other | AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION | |
| 200861830A | Other | IN | LEGACY PROVIDER IDENTIFIER (LPI) |
| 22001291A | Other | IN | INDIANA PROFESSIONAL LICENSING AGENCY LICENSE NUMBER |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22001291A | IN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209513600000",
"number": "1639344633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1125 DIXIE HWY",
"city": "MITCHELL",
"state": "IN",
"postal_code": "474466737",
"telephone_number": "812-583-6414",
"fax_number": "812-849-5225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1125 DIXIE HWY",
"city": "MITCHELL",
"state": "IN",
"postal_code": "474466737",
"telephone_number": "812-583-6414",
"fax_number": "812-849-5225"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "TERESA",
"middle_name": "DAWN",
"name_prefix": "Ms.",
"credential": "M.S. CCC-SP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-30",
"last_updated": "2008-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IN",
"license": "22001291A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION",
"identifier": "00211144",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LEGACY PROVIDER IDENTIFIER (LPI)",
"identifier": "200861830A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDIANA PROFESSIONAL LICENSING AGENCY LICENSE NUMBER",
"identifier": "22001291A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mitchell, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.