Susan Johnson, MS, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Sugar Hill, GA
NPI 1164529210 · NPPES record last updated Jan 5, 2009
Key facts
- NPI
- 1164529210
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SLP004972 (GA)
- Practice address
- 353 Ambrose Creek Dr
Sugar Hill, GA 30518-7870 - Phone
- (770) 235-4582
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP004972 | GA | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP004972 | GA | Yes |
Addresses
Primary practice location
353 Ambrose Creek Dr
Sugar Hill, GA 30518-7870
Mailing address
353 Ambrose Creek Dr
Sugar Hill, GA 30518-7870
Phone (770) 235-4582
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000940486C | Medicaid | GA |
Other providers in Sugar Hill, GA
- Integrated Healthcare Center of Sugar Hill LLC
- Melissa M Jaerling
- James G Davis DDS PC
- Sarah Johansson
- Michelle Davis Johnson
- Tiffany Monet Jones
- Bridgett Lynn Jorgensen
- Just Heal Counseling
- Daesung Kim
- Mark Andrew Kral
All providers in Sugar Hill, GA · Speech-Language Pathologist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 5, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.