NPI Code Detail JSON Logo

1659518934 NPI number — AMANDA NICHOLE LEWIS M.S., CCC-SLP

NPI Number: 1659518934
Health Care Provider/Practitioner: AMANDA NICHOLE LEWIS M.S., CCC-SLP

Information about “1659518934” NPI (AMANDA NICHOLE LEWIS M.S., CCC-SLP) exists in 1659518934 in HTML format HTML  |  1659518934 in plain Text format TXT  |  1659518934 in PDF (Portable Document Format) PDF  |  1659518934 in an XML format XML  formats.

NPI Number : 1659518934 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1659518934",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LEWIS",
    "FirstName": "AMANDA",
    "MiddleName": "NICHOLE",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "M.S., CCC-SLP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "ACKERLY",
    "OtherFirstName": "AMANDA",
    "OtherMiddleName": "NICHOLE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "M.S., CCC-SLP",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "24 PARK PL",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DELHI",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "13753-1215",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "607-437-6825",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "99 MAIN ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "DELHI",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "13753-1221",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "607-832-5200",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/08/2009",
    "LastUpdateDate": "03/13/2013",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "235Z00000X",
        "TaxonomyName": "Speech-Language Pathologist",
        "LicenseNumber": "016532",
        "LicenseNumberStateCode": "NY",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.