Mary Patricia Pichan, SLP CCC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP003055 Issued in GA

Practice address

2870 Peachtree Rd. #293
Atlanta, GA 32080

Phone

(904) 540-6762

NPI assigned

Jun 15, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

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.

• Brookhaven Speech,LLC

  • Speech-Language Pathologist
  • Atlanta, GA
  • NPI 1225541600
  Authorized official Same address or phone

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

{
    "created_epoch": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1285164855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2870 PEACHTREE RD. #293",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "32080",
            "telephone_number": "904-540-6762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2870 PEACHTREE RD. #293",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "32080",
            "telephone_number": "904-540-6762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICHAN",
        "first_name": "MARY",
        "middle_name": "PATRICIA",
        "credential": "SLP CCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP003055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Physiotherapy Associates, Inc.
• Tambari Simewa Piawah, MD
• Anthony Joseph Piazza, MD
• Michael Picard, PA
• Susan Elizabeth Picart, LCSW
• Melissa Sue Pichetto, NNP-BC
• David Matthew Pichulik, MD
• Dayana Pickard, PA
• Katherine Elizabeth Pickard, PHD
• Joseph P Pickavance, MS, OTR/L

• Speech-Language Pathologist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.