Stacey M Jolly-Lassiter, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

5790 Issued in NC

Practice address

4020 Barrett Dr
Suite 205
Raleigh, NC 27609-6624

Phone

(919) 787-4400

Fax

(919) 510-0070

NPI assigned

Dec 11, 2006

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 1

Other names 1

• Stacey Mae Jolly-Lassiter Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1437219342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8805 BOARS HEAD CT",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276131202",
            "telephone_number": "919-649-4690",
            "fax_number": "919-510-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 BARRETT DR",
            "address_2": "SUITE 205",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096624",
            "telephone_number": "919-787-4400",
            "fax_number": "919-510-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLY-LASSITER",
        "first_name": "STACEY",
        "middle_name": "M",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "5790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7411864",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "JOLLY-LASSITER",
            "middle_name": "MAE",
            "credential": "MS, CCC-SLP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Speech-Language Pathologist in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2026; 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.