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Active NPI 1104082205 Individual Practitioner Female Practitioner

Lisa Jane Fullenkamp , MA, CCC-SLP

Speech-Language Pathologist • Council Bluffs, IA

Professional Overview & Biography Verified Profile Summary

Lisa Fullenkamp, MA, CCC-SLP is a registered healthcare professional specializing in Speech-Language Pathologist in Council Bluffs, IA. Practice services are available at 3000 RISEN SON BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

3000 Risen Son Blvd

Council Bluffs, IA 515031911

Telephone 7123660286
Fax 7123660277
Associated Practice Facility / Clinic
🏢 Risen Son Christian Village Facility NPI 1134149529

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Council Bluffs, IA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 12.2 Yrs
Regional Practice Density
12 Specialists

Practicing in Council Bluffs, IA (1093 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License IA 01568

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners
Michelle Karmazin

Community Health Worker

NPI 1134379472
Dr. Abbey Rickard , DPT

Physical Therapist

NPI 1235480344

Doctor of Physical Therapy

Nancy Davis , COTA, L

Occupational Therapy Assistant

NPI 1255597316

Certified Occupational Therapy Assistant, L

Dr. Maria Medel , OTD, OTR, L

Occupational Therapist - Physical Rehabilitation

NPI 1386951507

Doctor of Occupational Therapy, Occupational Therapist Registered, L

Keene Ruff , OT

Community Health Worker

NPI 1558527614

Occupational Therapist

Amy Meinzer , MS, CCC-SLP

Speech-Language Pathologist

NPI 1649433095

Master of Science, Speech-Language Pathologist (Certificate of Clinical Competence)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 29, 2008

NPI status registered as active in NPPES database

📍
Updated Practice Location July 29, 2008

Registered at 3000 RISEN SON BLVD, COUNCIL BLUFFS, IA 515031911 (Tel: 7123660286)

📍
Updated Business Mailing Address July 29, 2008

Registered at 3000 RISEN SON BLVD, COUNCIL BLUFFS, IA 515031911 (Tel: 7123660286)

👤
Provider Name / Credentials Updated July 29, 2008

Recorded as LISA FULLENKAMP, MA, CCC-SLP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 29, 2008

Speech-Language Pathologist (License #01568 in IA)

🟢
Initial NPI Registration & Enumeration July 29, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1104082205
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 29, 2008
Last Update: July 29, 2008
Sole Proprietor: No

Mailing Address

3000 Risen Son Blvd

Council Bluffs, IA 515031911

Phone: 7123660286

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.