Active NPI
Anna Catherine Lack, M.S. CCC-SLP
- Speech-Language Pathologist
- Starkville, MS
National Provider Identifier
1912415456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- S4525
- Practice address
- 1411 Highway 389
Starkville, MS 39759 - Phone
- (662) 769-4888
- Fax
- (662) 338-5439
- NPI assigned
- Jan 18, 2018
- Last updated
- Feb 6, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 7476 | LA | |
| Speech-Language Pathologist | 235Z00000X | S4525 | MS | Primary |
Addresses
Primary practice location
1411 Highway 389
Starkville, MS 39759
Mailing address
1411 Highway 389
Starkville, MS 39759-8451
Phone (662) 769-4888
Other practice location 1
1514 Jefferson Hwy CT-4N
CT-4N
New Orleans, LA 70121
Phone (504) 842-4022
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S4525 | MS | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| OT 4 Kidz, LLC | Past | Accepting new patients | |
| Children's Rehab | Speech-Language Pathologist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Occupational Therapist
- Starkville, MS
- NPI 1558696658
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549411200000",
"number": "1912415456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1411 HIGHWAY 389",
"city": "STARKVILLE",
"state": "MS",
"postal_code": "397598451",
"telephone_number": "662-769-4888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1411 HIGHWAY 389",
"city": "STARKVILLE",
"state": "MS",
"postal_code": "39759",
"telephone_number": "662-769-4888",
"fax_number": "662-338-5439"
}
],
"practiceLocations": [
{
"address_1": "1514 Jefferson Hwy CT-4N",
"address_2": "CT-4N",
"address_purpose": "LOCATION",
"city": "New Orleans",
"state": "LA",
"postal_code": "70121",
"country_code": "US",
"telephone_number": "504-842-4022",
"fax_number": "504-842-5132",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LACK",
"first_name": "ANNA",
"middle_name": "CATHERINE",
"credential": "M.S. CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-18",
"last_updated": "2019-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "LA",
"license": "7476",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MS",
"license": "S4525",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Starkville, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.