Candice D Tetreault, MS/CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

NCSLP-10331 Issued in NC

Practice address

1357 Walter Reed Rd Ste 102
Fayetteville, NC 28304-4417

Phone

(910) 223-5543

NPI assigned

May 15, 2013

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

Credentials

Master of Science

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 and National Provider Directory roles.

• VPS Partners LLP

  • Speech-Language Pathologist
  • Fayetteville, NC
  • NPI 1538592605
  NPD (past)

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

{
    "created_epoch": "1368576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1053757237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16420 SPILLWAY DR",
            "city": "WAGRAM",
            "state": "NC",
            "postal_code": "283969563",
            "telephone_number": "910-813-9964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1357 WALTER REED RD STE 102",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044417",
            "telephone_number": "910-223-5543"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4811-E Hardware Dr. NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "87109",
            "country_code": "US",
            "telephone_number": "505-268-5933",
            "fax_number": "505-268-0184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TETREAULT",
        "first_name": "CANDICE",
        "middle_name": "D",
        "credential": "MS/CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-15",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "5458",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "NCSLP-10331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Terefenko
• Jantina Charlette Terry
• Joy Leanne Terry
• Garrett Michael Testi Sr., LCSW, CADC
• Tonja Teter, RN
• Lindsey Tew
• Jasmine R. Thagard, MSW, LCSWA
• Seema Rahul Thaker, DDS
• Prasad Vivekanand Thakur, MD
• Francis Trevor Thandroyen, MD, FACC

• Speech-Language Pathologist in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.