Healthcare Provider Details

I. General information

NPI: 1457042640
Provider Name (Legal Business Name): LORI E FITZGERALD MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LORI DAWN ELSBERRY

II. Dates (important events)

Enumeration Date: 05/17/2023
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 NE 46TH ST
KANSAS CITY MO
64116-2042
US

IV. Provider business mailing address

6209 N MERRIMAC CT
KANSAS CITY MO
64151-4763
US

V. Phone/Fax

Practice location:
  • Phone: 816-321-5000
  • Fax:
Mailing address:
  • Phone: 850-691-5034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ10901
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2024038647
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: