LISA JANE FULLENKAMP MA, CCC-SLP
NPI 1104082205
Speech-Language Pathologist in Council Bluffs, IA

Q: What is Lisa Fullenkamp's NPI number?

The NPI number for Lisa Fullenkamp is 1104082205. It was assigned to this individual provider in the NPPES registry on July 29, 2008.

Q: What is Lisa Fullenkamp's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Q: When was this NPI record last updated?

The NPPES record for Lisa Fullenkamp was last updated on July 29, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 29, 2008

3000 RISEN SON BLVD, COUNCIL BLUFFS, IA 51503(712) 366-0286(712) 366-0277 Get Directions Write a Review

NPPES record last updated: July 29, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Lisa Jane Fullenkamp Ma, Ccc-slp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LISA JANE FULLENKAMP MA, CCC-SLP (NPI 1104082205) is an individual speech-language pathologist provider in Council Bluffs, Iowa, licensed in Iowa (01568) and active in the NPI registry since July 2008.

NPPES Registry Identity

NPI1104082205

Entity TypeIndividualFemale

Primary Taxonomy235Z00000X

Provider Legal NameLISA JANE FULLENKAMPCredential: MA, CCC-SLP

Location Address3000 RISEN SON BLVDCouncil Bluffs, IA 51503-1911

Mailing Address3000 Risen Son BlvdCouncil Bluffs, IA 51503-1911 · (712) 366-0286 · Fax (712) 366-0277

Phone(712) 366-0286

Fax(712) 366-0277

Sole ProprietorNo

Enumeration DateJuly 29, 2008

✔ NPI 1104082205 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers

Taxonomy Code235Z00000X

License✔ Licensed in IA · 01568

Definition

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.

3000 RISEN SON BLVD, Council Bluffs, IA 51503

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