Sunnybrook Therapy Group, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP006105 Issued in GA

Legal business name

SUNNYBROOK THERAPY GROUP, LLC

Practice address

125 White River CT
Alpharetta, GA 30022-6192

Phone

(404) 704-6200

NPI assigned

Nov 8, 2016

Organization subpart

No

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

Authorized official

Name

Rebecca A Johnson, M.ED., CCC-SLP

Title

Speech Therapist/Co-Owner

Phone

(404) 704-6200

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1478563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478563200000",
    "number": "1205378296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 WHITE RIVER CT",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300226192",
            "telephone_number": "404-704-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 WHITE RIVER CT",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300226192",
            "telephone_number": "404-704-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNNYBROOK THERAPY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-08",
        "last_updated": "2016-11-08",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SPEECH THERAPIST/CO-OWNER",
        "authorized_official_telephone_number": "404-704-6200",
        "authorized_official_credential": "M.ED., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP006105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; 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.