Speech Assessment Center, Inc.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP006202 Issued in GA

Legal business name

SPEECH ASSESSMENT CENTER, INC.

Practice address

175 Bradford SQ Ste a
Fayetteville, GA 30215-1967

Phone

(678) 438-7168

Fax

(470) 377-8097

NPI assigned

Apr 15, 2009

Last updated

Dec 11, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

James Nelson

Title

Credentialing

Phone

(678) 438-7168

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1239753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544486400000",
    "number": "1467695734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 MCINTOSH PLACE DR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147384",
            "telephone_number": "678-438-7168",
            "fax_number": "707-377-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 BRADFORD SQ STE A",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302151967",
            "telephone_number": "678-438-7168",
            "fax_number": "470-377-8097"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "696 Battlecreek Rd",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Jonesboro",
            "state": "GA",
            "postal_code": "302361997",
            "country_code": "US",
            "telephone_number": "678-489-4277",
            "fax_number": "678-489-4356",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPEECH ASSESSMENT CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-15",
        "last_updated": "2018-12-11",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "678-438-7168"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP006202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003209834D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Fayetteville, GA
• Providers in Fayetteville, 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 Dec 11, 2018; 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.