Kristin Lenee Lucas, MS, CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Chatham, IL

NPI 1962067140 · NPPES record last updated May 3, 2019

Key facts

NPI
1962067140
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
146.009451 (IL)
Practice address
525 S College St
Chatham, IL 62629-1663
Phone
(217) 483-2411
NPI assigned
May 3, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
146.009451ILMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 146.009451 IL Yes

Addresses

Primary practice location

525 S College St
Chatham, IL 62629-1663

Mailing address

1413 W Ash St
Springfield, IL 62704-3405

Other names

  • Miss Kristin Lenee Moseley Former name

Other providers in Chatham, IL

All providers in Chatham, IL · Speech-Language Pathologist in Illinois

Sources for this page

Verify at the official NPI Registry.