Michelle Pearson McDaniel, M.S. CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Carthage, MS

NPI 1134400856 · NPPES record last updated Sep 8, 2011

Key facts

NPI
1134400856
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
S2925 (MS)
Practice address
730 Highway 35 S
Carthage, MS 39051-5802
Phone
(601) 267-8333
Fax
(601) 267-5550
NPI assigned
Sep 8, 2011
Sex
Female
Sole proprietor
No

Organizations & group practices 3

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.

Medicare Care Compare profile

Specialty
Qualified Speech Language Pathologist
Education
Other, 2004
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

200 W Martin Luther King Blvd
Suite 1000
Chattanooga, TN 37402-2571

PO Box
Suite 11407
Birmingham, AL 35246

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MS

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20260603002461 MS Practitioner - Qualified Speech Language Pathologist 3577034255 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
S2925MSMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sta-Home Health Agency of Carthage, Inc Past Accepting new patients
Sta-Home Health Agency of Jackson, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X S2925 MS Yes

Addresses

Primary practice location

730 Highway 35 S
Carthage, MS 39051-5802

Mailing address

117 Beatrice LN
Brandon, MS 39047-4607
Phone (601) 724-1114

Other providers in Carthage, MS

All providers in Carthage, MS · Speech-Language Pathologist in Mississippi

Sources for this page

Verify at the official NPI Registry.