NPIMap

Organization Active NPI

Destined Path Therapy Services LLC

  • Speech-Language Pathologist
  • Hampton, GA
National Provider Identifier
1023959749
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
DESTINED PATH THERAPY SERVICES LLC
Practice address
11009 Southwood Dr
Hampton, GA 30228-3498
Phone
(404) 913-2097
NPI assigned
Apr 6, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Authorized official

Name
Destiny Mack, M.S., CCC-SLPNPI 1043864432
Title
Owner
Phone
(404) 913-2097

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

11009 Southwood Dr
Hampton, GA 30228-3498

Mailing address

11009 Southwood Dr
Hampton, GA 30228-3498
Phone (404) 913-2097

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1775433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775433600000",
    "number": "1023959749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11009 SOUTHWOOD DR",
            "city": "HAMPTON",
            "state": "GA",
            "postal_code": "302283498",
            "telephone_number": "404-913-2097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11009 SOUTHWOOD DR",
            "city": "HAMPTON",
            "state": "GA",
            "postal_code": "302283498",
            "telephone_number": "404-913-2097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESTINED PATH THERAPY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-06",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-05",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "DESTINY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-913-2097",
        "authorized_official_credential": "M.S., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2026; 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.