Individual Expressions Therapy, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

INDIVIDUAL EXPRESSIONS THERAPY, LLC

Practice address

8329 Office Park Dr Ste a
Douglasville, GA 30134-6937

Phone

(770) 731-8772

Fax

(470) 300-0042

NPI assigned

Sep 12, 2017

Last updated

Mar 7, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Nilka Gordon, M.S., CCC-SLPNPI 1487067468

Title

Owner/Speech Pathologist

Phone

(770) 731-8772

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nilka Gordon

  • Speech-Language Pathologist
  • Atlanta, GA
  • NPI 1487067468
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1505174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741305600000",
    "number": "1073032884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8329 OFFICE PARK DR STE A",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301346937",
            "telephone_number": "770-731-8772",
            "fax_number": "470-300-0042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8329 OFFICE PARK DR STE A",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301346937",
            "telephone_number": "770-731-8772",
            "fax_number": "470-300-0042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIVIDUAL EXPRESSIONS THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-12",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "NILKA",
        "authorized_official_title_or_position": "OWNER/SPEECH PATHOLOGIST",
        "authorized_official_telephone_number": "770-731-8772",
        "authorized_official_name_prefix": "Mrs.",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003147217D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Douglasville, GA
• Providers in Douglasville, 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 Mar 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.