MEDICARE: MS. LISA D. HALPIN MS, CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist		NY
2	235Z00000X	Speech-Language Pathologist	SP-3392	NV

General Provider Information

NPI Number	:	1699022509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LISA D. HALPIN MS, CCC-SLP

Provider Business Mailing Address
First Line	:	PO BOX 6
Second Line	:
City	:	APULIA STATION
State	:	NY
Zip	:	13020-0006
Country	:	US
Telephone Number	:	315-420-3088
Fax Number	:

Provider Business Practice Location Address
First Line	:	2850 W HORIZON RIDGE PKWY STE 320
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-4395
Country	:	US
Telephone Number	:	702-564-4116
Fax Number	:	702-932-2403

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2012
Last Update Date	:	09/05/2022

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