Individual provider Active NPI

Lisa G. Klus, MA CCC SLP

  • Speech-Language Pathologist
  • Long Beach, NY
National Provider Identifier
1760784912
Registry record updated Nov 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
006313-1 Issued in NY
Practice address
240 W Olive St
Long Beach, NY 11561-3210
Phone
(516) 897-7251
NPI assigned
Nov 20, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2010

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 006313-1 NY Primary

Addresses

Primary practice location

240 W Olive St
Long Beach, NY 11561-3210

Mailing address

240 W Olive St
Long Beach, NY 11561-3210
Phone (516) 897-7251

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
006313-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1290211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290211200000",
    "number": "1760784912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 W OLIVE ST",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115613210",
            "telephone_number": "516-897-7251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 W OLIVE ST",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115613210",
            "telephone_number": "516-897-7251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUS",
        "first_name": "LISA",
        "middle_name": "G.",
        "name_prefix": "Mrs.",
        "credential": "MA CCC SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-20",
        "last_updated": "2010-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "006313-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2010; 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.