Individual provider Active NPI

Stacy Ann Lebeau, COTA/L

  • Occupational Therapy Assistant
  • Dartmouth, MA
National Provider Identifier
1801125984
Registry record updated Feb 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
3162 Issued in MA
Practice address
1 Posa PL
Dartmouth, MA 02747-2511
Phone
(508) 996-3391
NPI assigned
Dec 18, 2009
Last updated
Feb 26, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 3162 MA Primary

Addresses

Primary practice location

1 Posa PL
Dartmouth, MA 02747-2511

Mailing address

15 Restful Valley Rd
Tiverton, RI 02878-2523
Phone (401) 625-5934

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
3162MAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1261094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267142400000",
    "number": "1801125984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 RESTFUL VALLEY RD",
            "city": "TIVERTON",
            "state": "RI",
            "postal_code": "028782523",
            "telephone_number": "401-625-5934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 POSA PL",
            "city": "DARTMOUTH",
            "state": "MA",
            "postal_code": "027472511",
            "telephone_number": "508-996-3391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBEAU",
        "first_name": "STACY",
        "middle_name": "ANN",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-18",
        "last_updated": "2010-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MA",
            "license": "3162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dartmouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.