Samantha Lynn Liddle, MS,SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

14801 Issued in NC

Practice address

1289 Oliver St
Fayetteville, NC 28304-4450

Phone

(910) 483-8331

Fax

(910) 483-8335

NPI assigned

Apr 20, 2021

Last updated

May 20, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Coastal Speech Therapy Inc

  • Speech-Language Pathologist
  • Wilmington, NC
  • NPI 1750782462
  NPD
• Pediatric Developmental Therapy

  • Rehabilitation Practitioner
  • Fayetteville, NC
  • NPI 1710183991
  NPD (past)
• Pediatric Developmental Therapy

  • Speech-Language Pathologist
  • Fayetteville, NC
  • NPI 1730137779
  NPD (past)

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

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1255912259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 87294",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283047294",
            "telephone_number": "910-483-8331",
            "fax_number": "910-483-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1289 OLIVER ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044450",
            "telephone_number": "910-483-8331",
            "fax_number": "910-483-8335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIDDLE",
        "first_name": "SAMANTHA",
        "middle_name": "LYNN",
        "credential": "MS,SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-20",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "14801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liberty Healthcare Group, LLC (Liberty Home Care, LLC)
• Liberty Healthcare Group, LLC (Liberty Home Care, LLC)
• Liberty Medical Specialties, Inc
• Liberty Nursing Services, LLC (Liberty Nursing Services)
• Katherine J Liddle Saxton, M.D.
• Lieberman & Lieberman Optometry, PLLC (Professional Optometry)
• Ann K. Lieberman, O.D.
• Nathan A. Lieberman, O.D.
• Life Enhancement Services
• Life Enhancement Services

• Speech-Language Pathologist in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; 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.