Destiny Lacara Mack

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

PCET004155 Issued in GA

Practice address

3485 N Desert Dr Ste 105
East Point, GA 30344-5724

Phone

(678) 724-7033

NPI assigned

Jul 24, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Destined Path Therapy Services LLC

  • Speech-Language Pathologist
  • Hampton, GA
  • NPI 1023959749
  NPD Authorized official
• Bright Future Therapy Services

  • Hearing and Speech Clinic/Center
  • East Point, GA
  • NPI 1346046349
  NPD

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1043864432",
    "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": "404-831-2098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3485 N DESERT DR STE 105",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303445724",
            "telephone_number": "678-724-7033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "DESTINY",
        "middle_name": "LACARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-24",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "PCET004155",
            "primary": true
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "GA",
            "license": "SLPA000396",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Love Angels
• Julie Maier Lucas, CRNA
• Lula Gilliam & Associates, Inc
• Luxottica of America Inc.
• Tincie Marie Lynch
• Dominic Mack, MD
• John Robert Mack, LMT
• David Joseph Malebranche, M.D., M.P.H
• Ljubica Blaze Malinajdovska-Bass, PH.D., LPC
• Andrew James Malinchak, D.O.

• Speech-Language Pathologist in East Point, GA
• Providers in East Point, 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 Feb 20, 2025; 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.