Lisandra Jimenez, MA CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

41YS00389300 Issued in NJ

Practice address

151 Summit Ave
Summit, NJ 07901-2813

Phone

(908) 598-0228

NPI assigned

Jan 25, 2018

Last updated

Jan 25, 2018By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1516838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516838400000",
    "number": "1740788637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "553 MINE BROOK RD APT 2",
            "city": "BERNARDSVILLE",
            "state": "NJ",
            "postal_code": "079241913",
            "telephone_number": "732-829-2353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 SUMMIT AVE",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079012813",
            "telephone_number": "908-598-0228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "LISANDRA",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-25",
        "last_updated": "2018-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00389300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE SPEECH LANGUAGE PATHOLOGIST",
            "identifier": "41YS00389300",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Robert Jaskolski
• Archana Jayakumar
• Jeannette Devaris Corporation
• Emily Landa Jeffries, MD
• Ashlie Jernigan
• Rachel Anna Joe
• John a Robina DMD, Fagd, PA
• John M Boozan MD PA
• Alison W Johnson, PSYD
• Christina Nicole Johnson

• Speech-Language Pathologist in Summit, NJ
• Providers in Summit, NJ by specialty
• Speech-Language Pathologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2018; 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.