Provider Demographics
NPI:1306919477
Name:LAPIDUS, KIMBERLY LYNN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:LYNN
Last Name:LAPIDUS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:KIM
Other - Middle Name:LYNN
Other - Last Name:LAPIDUS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:718 BRESSLYN RD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2602
Mailing Address - Country:US
Mailing Address - Phone:615-352-9096
Mailing Address - Fax:615-352-9096
Practice Address - Street 1:718 BRESSLYN RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2602
Practice Address - Country:US
Practice Address - Phone:615-352-9096
Practice Address - Fax:615-352-9096
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000003082235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5441017Medicaid
TN4125244OtherBCBS PROVIDER NUMBER