Provider Demographics
NPI:1629442827
Name:LENINGER, LAUREN JENNIFER (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:JENNIFER
Last Name:LENINGER
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:752 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-3900
Mailing Address - Country:US
Mailing Address - Phone:631-423-7700
Mailing Address - Fax:631-423-7706
Practice Address - Street 1:752 PARK AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-3900
Practice Address - Country:US
Practice Address - Phone:631-423-7700
Practice Address - Fax:631-423-7706
Is Sole Proprietor?:No
Enumeration Date:2015-11-25
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023579235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist