Individual provider Active NPI

Lesley Jordana Daniel, O.T

  • Occupational Therapist
  • Waltham, MA
National Provider Identifier
1790179158
Registry record updated Mar 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
11523 Issued in MA
Practice address
411 Waverley Oaks Rd Ste 305
Waltham, MA 02452-8448
Phone
(781) 894-6564
NPI assigned
Mar 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 11523 MA Primary

Addresses

Primary practice location

411 Waverley Oaks Rd Ste 305
Waltham, MA 02452-8448

Mailing address

411 Waverley Oaks Rd Ste 305
Waltham, MA 02452-8448
Phone (781) 894-6564

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

State licenses

LicenseStateTypeSpecialty
11523MAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427155200000",
    "number": "1790179158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 WAVERLEY OAKS RD STE 305",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024528448",
            "telephone_number": "781-894-6564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 WAVERLEY OAKS RD STE 305",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024528448",
            "telephone_number": "781-894-6564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "LESLEY",
        "middle_name": "JORDANA",
        "name_prefix": "Mrs.",
        "credential": "O.T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-24",
        "last_updated": "2015-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "11523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2015; 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.