Individual provider Active NPI

Leslie Palliere, MS-CCC/SLP

  • Speech-Language Pathologist
  • Mooresville, NC
National Provider Identifier
1003043225
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
14406 Issued in NC
Practice address
134 Infield CT
Mooresville, NC 28117-8026
Phone
(704) 799-6824
Fax
(704) 799-6825
NPI assigned
Jun 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP 008361 GA
Speech-Language Pathologist 235Z00000X SLP.5423 SLP SC
Speech-Language Pathologist 235Z00000X SLP.5423 SC
Speech-Language Pathologist 235Z00000X 7754734-4102 UT
Speech-Language Pathologist 235Z00000X 018763-1 NY
Speech-Language Pathologist 235Z00000X 1149660 NY
Speech-Language Pathologist 235Z00000X 008361 GA
Speech-Language Pathologist 235Z00000X SLP008361 GA
Speech-Language Pathologist 235Z00000X 567658 UT
Speech-Language Pathologist 235Z00000X 14406 NC Primary

Addresses

Primary practice location

134 Infield CT
Mooresville, NC 28117-8026

Mailing address

4316 Pinewood Ter
Kernersville, NC 27284-9523
Phone (914) 525-3070

Other practice location 1

117 Hillsborough Ln
Aiken, SC 29803
Phone (914) 525-3070

Other practice location 2

4316 Pinewood Ter
Kernersville, NC 27284-9523
Phone (914) 525-3070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
14406NCMDGeneral Practice Dentistry
018763-1NYMDPhysical Therapist
SLP 008361GAMDSpeech-Language Pathologist
SLP008361GAMDSpeech-Language Pathologist
1149660NYMDSpeech-Language Pathologist
SLP.5423SCMDSpeech-Language Pathologist
SLP.5423 SLPSCMDSpeech-Language Pathologist
567658UTMDSpeech-Language Pathologist
7754734-4102UTMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lolly Therapeutics, LLC Speech-Language Pathologist PastSince Apr 24, 2022 Accepting new patients
Integrative Therapy Concepts PastSince Apr 24, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1003043225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4316 PINEWOOD TER",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272849523",
            "telephone_number": "914-525-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 INFIELD CT",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178026",
            "telephone_number": "704-799-6824",
            "fax_number": "704-799-6825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 Hillsborough Ln",
            "address_purpose": "LOCATION",
            "city": "Aiken",
            "state": "SC",
            "postal_code": "29803",
            "country_code": "US",
            "telephone_number": "914-525-3070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4316 Pinewood Ter",
            "address_purpose": "LOCATION",
            "city": "Kernersville",
            "state": "NC",
            "postal_code": "272849523",
            "country_code": "US",
            "telephone_number": "914-525-3070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALLIERE",
        "first_name": "LESLIE",
        "name_prefix": "Mrs.",
        "credential": "MS-CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-15",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP 008361",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "SLP.5423 SLP",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "SLP.5423",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "UT",
            "license": "7754734-4102",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "018763-1",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "1149660",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "008361",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP008361",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "UT",
            "license": "567658",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "14406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.