Lisa Knierim Ivanov, CCC/SLP
NPI 1972847192ActiveIndividual· Speech-Language Pathologist· Manassas, VA
Speech-Language Pathologist (CCC/SLP) with Legacy Healthcare Services Inc, practicing in Manassas, Virginia. Enrolled in Medicare as practitioner - qualified speech language pathologist and practitioner - qualified speech language pathologist.
Overview
| NPI | 1972847192 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | CCC/SLP |
| Sole proprietor | No |
| NPI issued | Nov 15, 2012 |
| Last updated in NPPES | Mar 21, 2013 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Speech-Language Pathologist Primary | 235Z00000X | 2202006805 | VA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Qualified Speech Language Pathologist (DC); Practitioner - Qualified Speech Language Pathologist (VA) |
|---|
Education and affiliations
| Graduation year | 1990 |
|---|---|
| Medicare specialty | Qualified Speech Language Pathologist |
Medical group
- Legacy Healthcare Services IncGreenville, SC · 3,223 clinicians
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