Lucille A Wakefield, MA/CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SL000889L Issued in PA

Practice address

1500 Woodland St
Lebanon, PA 17042-6563

Phone

(717) 675-2174

Fax

(717) 270-6819

NPI assigned

Oct 26, 2009

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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.

• Community Services Group, Inc.

  • Community/Behavioral Health Agency
  • Mountville, PA
  • NPI 1265426084
  NPD (past)

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

{
    "created_epoch": "1256515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256515200000",
    "number": "1659607646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 HIGHLAND DR",
            "address_2": "P.O. BOX 527",
            "city": "MOUNTVILLE",
            "state": "PA",
            "postal_code": "175541232",
            "telephone_number": "717-285-7121",
            "fax_number": "717-285-5302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 WOODLAND ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170426563",
            "telephone_number": "717-675-2174",
            "fax_number": "717-270-6819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKEFIELD",
        "first_name": "LUCILLE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "MA/CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-26",
        "last_updated": "2009-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL000889L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rani Heather Waddell, D.C.
• Abdullah Wagley
• Bobbi Wagner
• Debra Ann Wagner, RN591717
• Musaddiq Waheed, MD
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP.
• Melanie A Walborn, MTBC
• Joseph Jude Walden, MD
• Gabrielle Nicole Wall, PMHNP-BC

• Speech-Language Pathologist in Lebanon, PA
• Providers in Lebanon, PA by specialty
• Speech-Language Pathologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2009; 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.