Individual provider Active NPI

Leslee Michelle Lasater, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Wagoner, OK
National Provider Identifier
1659451342
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2169 Issued in OK
Practice address
29588 State Highway 51
Wagoner, OK 74467-8619
Phone
(918) 485-1522
NPI assigned
Oct 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X
Speech-Language Pathologist 235Z00000X 2169 OK Primary

Addresses

Primary practice location

29588 State Highway 51
Wagoner, OK 74467-8619

Mailing address

29588 State Highway 51
Wagoner, OK 74467-8619
Phone (918) 441-4157

Other identifiers 2

IdentifierTypeStateIssuer
100664140BOtherOKWAIVER CONTRACT FOR DDSD
100664140CMedicaidOK

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 Arts

State licenses

LicenseStateTypeSpecialty
2169OKMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1659451342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29588 STATE HIGHWAY 51",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "744678619",
            "telephone_number": "918-441-4157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29588 STATE HIGHWAY 51",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "744678619",
            "telephone_number": "918-485-1522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASATER",
        "first_name": "LESLEE",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "2169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WAIVER CONTRACT FOR DDSD",
            "identifier": "100664140B",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100664140C",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wagoner, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; 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.