Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Lisa Knierim Ivanov, CCC/SLP

Individual provider Speech-Language Pathologist · NPI 1972847192

Mrs. Lisa Knierim Ivanov, CCC/SLP is a Qualified Speech Language Pathologist in Manassas, Virginia. Qualified in 1990, 36 years ago. Practices with Legacy Healthcare Services Inc, a 3,624-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
36
Licensed in
VA
In the registry since
2012
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Practice location Address checks out

8575 Rixlew Ln
Manassas, VA 20109-3701
Phone: (703) 257-2941
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 2202006805 (VA)

Record details

NPI number1972847192
Entity typeIndividual (Type 1)
GenderFemale
Credentials CCC/SLP
Sole proprietorNo
NPI enumeratedNovember 15, 2012
Last updated in NPPESMarch 21, 2013

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyQUALIFIED SPEECH LANGUAGE PATHOLOGIST
Medical schoolOTHER
Graduated 1990 (36 years in practice)
Group practice Legacy Healthcare Services Inc — 3624 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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