Individual provider Active NPI

Lisa Guerra, MS, CCC-SLP

  • Speech-Language Pathologist
  • Boston, MA
National Provider Identifier
1710128616
Registry record updated Mar 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3603 Issued in MA
Practice address
30 Leon St
503 Behrakis Health Sciences Center
Boston, MA 02115-5009
Phone
(617) 373-2492
Fax
(617) 373-8756
NPI assigned
Mar 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2009

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 3603 MA Primary

Addresses

Primary practice location

30 Leon St
503 Behrakis Health Sciences Center
Boston, MA 02115-5009

Mailing address

42 Washington St
#4
Charlestown, MA 02129-3231

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
3603MAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern University Speech-Language Pathologist Past Accepting new patients
Northeastern University Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 2

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": "1237766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237766400000",
    "number": "1710128616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 WASHINGTON ST",
            "address_2": "#4",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021293231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 LEON ST",
            "address_2": "503 BEHRAKIS HEALTH SCIENCES CENTER",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155009",
            "telephone_number": "617-373-2492",
            "fax_number": "617-373-8756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRA",
        "first_name": "LISA",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-23",
        "last_updated": "2009-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "3603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

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