Stacy Bennett, Speech Language Pathologist, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

005003SLP Issued in GA

Legal business name

STACY BENNETT, SPEECH LANGUAGE PATHOLOGIST, LLC

Practice address

2186 Smoke Stone Cir
Marietta, GA 30062-6089

Phone

(770) 998-9359

NPI assigned

Oct 22, 2014

Organization subpart

No

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

Authorized official

Name

Stacy Bennett, M.A.CCC-SLP

Title

Speech Language Pathologist

Phone

(678) 770-9362

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413936000000",
    "number": "1346644101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2186 SMOKE STONE CIR",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300626089",
            "telephone_number": "770-998-9359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2186 SMOKE STONE CIR",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300626089",
            "telephone_number": "770-998-9359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STACY BENNETT, SPEECH LANGUAGE PATHOLOGIST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-22",
        "last_updated": "2014-10-22",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "678-770-9362",
        "authorized_official_credential": "M.A.CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "005003SLP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2014; 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.