Stephanie Perez, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP009114 Issued in GA

Practice address

3615 Braselton Hwy Ste 103
Dacula, GA 30019-5907

Phone

(678) 377-9634

Fax

(678) 377-9609

NPI assigned

Jun 6, 2016

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 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.

• Milton Speech Pathology, LLC

  • Speech-Language Pathologist
  • Roswell, GA
  • NPI 1679020499
  NPD (past)
• Rightstart Therapy Service, Inc.

  • Speech-Language Pathologist
  • Snellville, GA
  • NPI 1053542092
  NPD (past)

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586217600000",
    "number": "1104275635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3615 BRASELTON HWY STE 103",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300195907",
            "telephone_number": "678-377-9634",
            "fax_number": "678-377-9609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3615 BRASELTON HWY STE 103",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300195907",
            "telephone_number": "678-377-9634",
            "fax_number": "678-377-9609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "STEPHANIE",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-06",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP009114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric Therapy Services Network
• Pediatric Vision Development Center of Gwinnett
• Pellynash Medical Services
• David Penaranda, PT
• Robin Perez
• Tracy Alexander Perez, M.S., CCC-SLP
• Perfect Home Care, LLC
• Coral Elizabeth Quinn Perniciaro, D.P.T.
• Personal Primary Care of Georgia
• Marissa Peterson, PHARMD

• Speech-Language Pathologist in Dacula, GA
• Providers in Dacula, 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 7, 2020; 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.