Emma Provenzano, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

15389 Issued in NC

Practice address

501 Covil Ave Ste 100
Wilmington, NC 28403-2678

Phone

(910) 792-6706

NPI assigned

Dec 5, 2021

Last updated

May 25, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Emma Provenzano Professional name

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

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sol Speech Therapy PLLC

  • Speech-Language Pathologist
  • Wilmington, NC
  • NPI 1154159820
  NPD Authorized official

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

{
    "created_epoch": "1638662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1164180378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6012 NETTLE CIR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284053782",
            "telephone_number": "802-688-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 COVIL AVE STE 100",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032678",
            "telephone_number": "910-792-6706"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "37 Raymond Ave",
            "address_purpose": "LOCATION",
            "city": "Somerville",
            "state": "MA",
            "postal_code": "021441209",
            "country_code": "US",
            "telephone_number": "802-688-4400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROVENZANO",
        "first_name": "EMMA",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-05",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "78102",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "15389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMMA",
            "last_name": "PROVENZANO",
            "credential": "M.S., CCC-SLP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Progressive Speech Services
• Promina Health PC
• Nicole Proscia, MD
• Skyler Prosser, MS, RDN, LDN
• Provantage Transport, LLC
• Debi J Pruitt, LPCA
• Angelica Shaver Pryor, NP
• Stacey Leigh Psikula, CRNA
• Psychwellnow
• PT by the Sea, Inc

• Speech-Language Pathologist in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; 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.