Individual provider Active NPI

Lauren Leija, MA, CCC-SLP

  • Speech-Language Pathologist
  • South Lyon, MI
National Provider Identifier
1730415290
Registry record updated Jan 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
12109190 Issued in MI
Practice address
301 S Lafayette St
South Lyon, MI 48178-1407
Phone
(248) 486-1110
Fax
(248) 486-3318
NPI assigned
Oct 19, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2016

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 12109190 MI Primary

Addresses

Primary practice location

301 S Lafayette St
South Lyon, MI 48178-1407

Mailing address

14153 Rick Dr
Shelby Township, MI 48315-2951
Phone (586) 933-3387

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 Arts

State licenses

LicenseStateTypeSpecialty
12109190MIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1255910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453939200000",
    "number": "1730415290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14153 RICK DR",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483152951",
            "telephone_number": "586-933-3387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S LAFAYETTE ST",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481781407",
            "telephone_number": "248-486-1110",
            "fax_number": "248-486-3318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIJA",
        "first_name": "LAUREN",
        "name_prefix": "Mrs.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-19",
        "last_updated": "2016-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "12109190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Lyon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2016; 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.