McKenzie Washington Dodson, M. ED., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP012979 Issued in GA

Practice address

382 Racetrack Rd
McDonough, GA 30252-1022

Phone

(678) 205-5437

NPI assigned

Apr 16, 2024

Last updated

Apr 16, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

Practice roles

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

• Kidsplay Therapy Center, Inc.

  • Specialist
  • Loganville, GA
  • NPI 1619054319
  NPD (past)

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

{
    "created_epoch": "1713225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1033963046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2256 HIGHWAY 36 W",
            "city": "JACKSON",
            "state": "GA",
            "postal_code": "302335813",
            "telephone_number": "770-286-9981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 RACETRACK RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302521022",
            "telephone_number": "678-205-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODSON",
        "first_name": "MCKENZIE",
        "middle_name": "WASHINGTON",
        "credential": "M. ED., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-16",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP012979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Faith Dillard, N.P.
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• Thu Anh Doan, DMD
• Domi Healthcare Services, LLC
• Tanequa S Dorsey, LCSW
• Andrew Doughan, MD
• April Douglas, RRT
• Miriam W Douglas, PHARM D

• Speech-Language Pathologist in McDonough, GA
• Providers in McDonough, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; 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.