Active NPI
Lisa Sutton, MA, CCC/SLP
- Speech-Language Pathologist
- Watervliet, MI
National Provider Identifier
1780153403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 7101003999
- Practice address
- 400 Medical Park Dr
Watervliet, MI 49098-9225 - Phone
- (269) 463-3111
- NPI assigned
- Nov 26, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 7101003999 | MI | Primary |
Addresses
Primary practice location
400 Medical Park Dr
Watervliet, MI 49098-9225
Mailing address
400 Medical Park Dr
Watervliet, MI 49098-9225
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7101003999 | MI | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543190400000",
"number": "1780153403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 MEDICAL PARK DR",
"city": "WATERVLIET",
"state": "MI",
"postal_code": "490989225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 MEDICAL PARK DR",
"city": "WATERVLIET",
"state": "MI",
"postal_code": "490989225",
"telephone_number": "269-463-3111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUTTON",
"first_name": "LISA",
"credential": "MA, CCC/SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-11-26",
"last_updated": "2018-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MI",
"license": "7101003999",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Watervliet, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.