Active NPI
Susan Elizabeth Lichtenberg
- Speech-Language Pathologist
- Marshall, MO
National Provider Identifier
1992204978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2016032495
- Practice address
- 860 W. Vest St.
Marshall, MO 65340 - Phone
- (660) 886-7414
- NPI assigned
- Feb 6, 2018
- Last updated
- Sep 4, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2016032495 | MO | Primary |
Addresses
Primary practice location
860 W. Vest St.
Marshall, MO 65340
Mailing address
860 W. Vest St.
Marshall, MO 65340
Phone (660) 886-7414
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2016032495 | MO | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567555200000",
"number": "1992204978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "860 W. VEST ST.",
"city": "MARSHALL",
"state": "MO",
"postal_code": "65340",
"telephone_number": "660-886-7414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "860 W. VEST ST.",
"city": "MARSHALL",
"state": "MO",
"postal_code": "65340",
"telephone_number": "660-886-7414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LICHTENBERG",
"first_name": "SUSAN",
"middle_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-06",
"last_updated": "2019-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MO",
"license": "2016032495",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marshall, MO
- Delee B Leach, PTA, ATC
- Rachel Leavitt, RN, NC-BC, CD
- Legendary Health Care Center, L.L.C. (Legendary Health Care Center)
- Legendary Nursing & Rehabilitation Center, LLC
- Legendary SNF Opco LLC (Legendary Health Care Center)
- Lifetime Dental Associates
- Ivet Lloansi Rodriguez, ATC
- Matthew Long, ATC, LAT
- Annex Luberisse, ND
- Dylan Gerald Luebbert
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.