Individual provider Active NPI

Katrina Mary Mandel, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Greenville, SC
National Provider Identifier
1225659048
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
6952 Issued in SC
Practice address
50 Bear Dr
Greenville, SC 29605-4458
Phone
(864) 241-6222
NPI assigned
May 4, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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 6952 SC Primary

Addresses

Primary practice location

50 Bear Dr
Greenville, SC 29605-4458

Mailing address

50 Bear Dr
Greenville, SC 29605-4458
Phone (864) 241-6222

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
6952SCMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1588550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1225659048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 BEAR DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054458",
            "telephone_number": "864-241-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 BEAR DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054458",
            "telephone_number": "864-241-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDEL",
        "first_name": "KATRINA",
        "middle_name": "MARY",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-04",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "6952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; 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.