Pediatric Speech Therapy Services

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

3360 Issued in SC

Legal business name

PEDIATRIC SPEECH THERAPY SERVICES

Practice address

820 Kipling Dr
Columbia, SC 29205-2036

Phone

(803) 315-5252

Fax

(803) 787-2973

NPI assigned

Aug 24, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Marymac Williams, MA, CCC/SLP

Title

Speech-Language Pathologist

Phone

(803) 315-5252

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1251072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251072000000",
    "number": "1265665335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 KIPLING DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292052036",
            "telephone_number": "803-315-5252",
            "fax_number": "803-787-2973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 KIPLING DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292052036",
            "telephone_number": "803-315-5252",
            "fax_number": "803-787-2973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC SPEECH THERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-24",
        "last_updated": "2009-08-24",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "MARYMAC",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "803-315-5252",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA, CCC/SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "3360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SA0726",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Columbia, SC
• Providers in Columbia, SC by specialty
• Speech-Language Pathologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2009; 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.