Active NPI
Lydia Susanna Pauchnik
- Speech-Language Pathologist
- MC Clure, PA
National Provider Identifier
1790376804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 013926
- Practice address
- 1001 Mountain Springs LN
MC Clure, PA 17841-9260 - Phone
- (717) 856-8181
- NPI assigned
- Feb 1, 2021
- Reactivated
- Apr 7, 2021
- Sex
- Female
- Sole proprietor
- No
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 | 013926 | PA | Primary |
Addresses
Primary practice location
1001 Mountain Springs LN
MC Clure, PA 17841-9260
Mailing address
1001 Mountain Springs LN
MC Clure, PA 17841-9260
Phone (717) 856-8181
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013926 | PA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617753600000",
"number": "1790376804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 MOUNTAIN SPRINGS LN",
"city": "MC CLURE",
"state": "PA",
"postal_code": "178419260",
"telephone_number": "717-856-8181"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 MOUNTAIN SPRINGS LN",
"city": "MC CLURE",
"state": "PA",
"postal_code": "178419260",
"telephone_number": "717-856-8181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAUCHNIK",
"first_name": "LYDIA",
"middle_name": "SUSANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-01",
"last_updated": "2021-04-07",
"certification_date": "2021-04-07",
"deactivation_date": "2021-02-17",
"reactivation_date": "2021-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "PA",
"license": "013926",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in MC Clure, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.