Individual provider Active NPI

Amanda Costa Sakraida, M.ED., SLP

  • Speech-Language Pathologist
  • Marietta, GA
National Provider Identifier
1104764257
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
707 Whitlock Ave SW Ste D32
Marietta, GA 30064-3083
Phone
(770) 927-7424
NPI assigned
Mar 23, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X GA Primary

Addresses

Primary practice location

707 Whitlock Ave SW Ste D32
Marietta, GA 30064-3083

Mailing address

2633 Saint Charles LN NW
Kennesaw, GA 30144-6106
Phone (404) 781-4012

Other practice location 1

2633 Saint Charles Ln NW
Kennesaw, GA 30144-6106
Phone (404) 781-4012

Other names 1

  • Amanda Costa Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Education

NPI Registry JSON

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

{
    "created_epoch": "1774224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1104764257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2633 SAINT CHARLES LN NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301446106",
            "telephone_number": "404-781-4012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 WHITLOCK AVE SW STE D32",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300643083",
            "telephone_number": "770-927-7424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2633 Saint Charles Ln NW",
            "address_purpose": "LOCATION",
            "city": "Kennesaw",
            "state": "GA",
            "postal_code": "301446106",
            "country_code": "US",
            "telephone_number": "404-781-4012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COSTA SAKRAIDA",
        "first_name": "AMANDA",
        "credential": "M.ED., SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-23",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "COSTA",
            "credential": "M.ED., SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2026; 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.