Organization Active NPI

Magnolia Speech & Feeding Therapy LLC

  • Speech-Language Pathologist
  • Charleston, SC
National Provider Identifier
1104774348
Registry record updated Mar 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
MAGNOLIA SPEECH & FEEDING THERAPY LLC
Practice address
29 Fenwick Dr Unit a
Charleston, SC 29407-7537
Phone
(843) 619-7120
NPI assigned
Mar 20, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2026

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

Authorized official

Name
Emma Louise Tracy, MS, CCC-SLP, CLCNPI 1790502193
Title
Speech-Language Pathologist
Phone
(843) 619-7120

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

29 Fenwick Dr Unit a
Charleston, SC 29407-7537

Mailing address

112 Hawkins Island Cir
St Simons Island, GA 31522-1771

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1773964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773964800000",
    "number": "1104774348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 HAWKINS ISLAND CIR",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315221771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 FENWICK DR UNIT A",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077537",
            "telephone_number": "843-619-7120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA SPEECH & FEEDING THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-20",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A",
        "authorized_official_last_name": "TRACY",
        "authorized_official_first_name": "EMMA",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "843-619-7120",
        "authorized_official_credential": "MS, CCC-SLP, CLC"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.