Madisyn Bolinger

Individual provider Active NPI Speech-Language Pathologist · Ravenel, SC

NPI 1124972070 · NPPES record last updated Feb 25, 2026

Key facts

NPI
1124972070
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SLP.9126 (SC)
Practice address
5540 Old Jacksonboro Rd
Ravenel, SC 29470-5201
Phone
(843) 889-9411
NPI assigned
Feb 25, 2026
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
SLP.9126SCMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP.9126 SC Yes

Addresses

Primary practice location

5540 Old Jacksonboro Rd
Ravenel, SC 29470-5201

Mailing address

83 Avonshire Dr
Summerville, SC 29483-7367

Other providers in Ravenel, SC

All providers in Ravenel, SC · Speech-Language Pathologist in South Carolina

Sources for this page

Verify at the official NPI Registry.