Provider Demographics
NPI:1255516555
Name:KIRK, LANEY TOUPS (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:LANEY
Middle Name:TOUPS
Last Name:KIRK
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:LANEY
Other - Middle Name:LYNN
Other - Last Name:TOUPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:210 TWIN OAKS DR
Mailing Address - Street 2:
Mailing Address - City:RACELAND
Mailing Address - State:LA
Mailing Address - Zip Code:70394-2758
Mailing Address - Country:US
Mailing Address - Phone:985-502-0037
Mailing Address - Fax:
Practice Address - Street 1:110 BOWIE RD
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-6703
Practice Address - Country:US
Practice Address - Phone:985-435-3106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-04
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5675235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAUSES NPIOtherBCBS-LA
LA386929YWWBOtherMEDICARE PTAN
LA386929YUZ5OtherMEDICARE PTAN
008093OtherOPTUM