Individual provider Active NPI

Jennifer Dilallo Haab, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Raleigh, NC
National Provider Identifier
1215566039
Registry record updated Jul 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
30001312 Issued in NC
Practice address
5308 Seaspray LN
Raleigh, NC 27610-5781
Phone
(314) 885-4812
NPI assigned
Apr 3, 2020
Last updated
Jul 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 30001312 NC Primary

Addresses

Primary practice location

5308 Seaspray LN
Raleigh, NC 27610-5781

Mailing address

5308 Seaspray LN
Raleigh, NC 27610-5781
Phone (314) 885-4812

Other names 1

  • Jennifer Dilallo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230322001332 NC Practitioner - Qualified Speech Language Pathologist 2466826417 Reassigns benefits to 1 organization
I20230724001615 FL Practitioner - Qualified Speech Language Pathologist 2466826417 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

141 N Main St
Fuquay Varina, NC 27526-1933

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SA21655FLMDSpeech-Language Pathologist
30001312NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Capitol City Speech Therapy, LLC Speech-Language Pathologist CurrentSince Jun 26, 2025 Accepting new patients

Locations

141 N Main St
Fuquay Varina, NC 27526
Phone (919) 577-6807

6845 Knightdale Blvd
Ste 102
Knightdale, NC 27545
Phone (919) 577-6807

1330 Saint Marys St
Ste 100
Raleigh, NC 27605
Phone (919) 577-6807

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783728000000",
    "number": "1215566039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5308 SEASPRAY LN",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276105781",
            "telephone_number": "314-885-4812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5308 SEASPRAY LN",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276105781",
            "telephone_number": "314-885-4812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAB",
        "first_name": "JENNIFER",
        "middle_name": "DILALLO",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-03",
        "last_updated": "2026-07-11",
        "certification_date": "2026-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "30001312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "DILALLO",
            "credential": "M.S., CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.