Katie Rackley Decoudres, M.ED., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP007048 Issued in GA

Practice address

701 Baytree Rd
Suite C
Valdosta, GA 31602-2880

Phone

(229) 253-1009

Fax

(229) 253-1039

NPI assigned

Jul 29, 2013

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

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

{
    "created_epoch": "1375056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380067200000",
    "number": "1376985697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 BAYTREE RD",
            "address_2": "SUITE C",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022880",
            "telephone_number": "229-253-1009",
            "fax_number": "229-253-1039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 BAYTREE RD",
            "address_2": "SUITE C",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022880",
            "telephone_number": "229-253-1009",
            "fax_number": "229-253-1039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECOUDRES",
        "first_name": "KATIE",
        "middle_name": "RACKLEY",
        "credential": "M.ED., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-29",
        "last_updated": "2013-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP007048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003136404A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHA",
            "identifier": "12153747",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandon Dean, PTA
• Raymond Dean, LPC
• Deanna Folsom LCSW PC
• Deborah F McDonald OD PC
• Meredith Emily Decesare, NP-C
• Robin M Dees, LPC
• Salome Ewurasi Defore, MD
• Brij Delada
• Heather Shay Delaney, MED CCC-SLP
• Tiffany M Delice, M.D.

• Speech-Language Pathologist in Valdosta, GA
• Providers in Valdosta, 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 Sep 25, 2013; 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.