Individual provider Active NPI

Laiken Odum

  • Speech-Language Pathologist
  • Mount Pleasant, SC
National Provider Identifier
1386335966
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8378 Issued in SC
Practice address
1051 Johnnie Dodds Blvd Ste G
Mount Pleasant, SC 29464-3100
Phone
(843) 654-9694
NPI assigned
May 16, 2023
Last updated
Feb 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X NU
Speech-Language Pathologist 235Z00000X 8378 SC Primary

Addresses

Primary practice location

1051 Johnnie Dodds Blvd Ste G
Mount Pleasant, SC 29464-3100

Mailing address

1805 Shoremeade Rd Ste 317
Mount Pleasant, SC 29464-7313

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8378SCMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1684195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1386335966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 SHOREMEADE RD STE 317",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294647313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 JOHNNIE DODDS BLVD STE G",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294643100",
            "telephone_number": "843-654-9694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODUM",
        "first_name": "LAIKEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-16",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "8378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; 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.