Individual provider Active NPI

Joanna Chanlett Prose, CCC-SLP

  • Speech-Language Pathologist
  • Durham, NC
National Provider Identifier
1164899076
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
11611 Issued in NC
Practice address
4328 Pin Oak Dr
Durham, NC 27707-5272
Phone
(919) 824-1534
NPI assigned
Aug 26, 2015
Last updated
Jun 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 7101008738 MI
Speech-Language Pathologist 235Z00000X 11611 NC Primary

Addresses

Primary practice location

4328 Pin Oak Dr
Durham, NC 27707-5272

Mailing address

123 Cedar Hills Cir
Chapel Hill, NC 27514-1628
Phone (984) 330-4377

Other names 1

  • Johanna Prose Other name

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11611NCMDMental Health Counselor
7101008738MIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1440547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1164899076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 CEDAR HILLS CIR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275141628",
            "telephone_number": "984-330-4377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4328 PIN OAK DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277075272",
            "telephone_number": "919-824-1534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROSE",
        "first_name": "JOANNA",
        "middle_name": "CHANLETT",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-26",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101008738",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "11611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHANNA",
            "last_name": "PROSE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; 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.