Active NPI
Lindsey Jeanne Woodruff, M.S.
- Speech-Language Pathologist
- Moncks Corner, SC
National Provider Identifier
1508393752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 6491
- Practice address
- 421 Barony St Ste 3
Moncks Corner, SC 29461-3145 - Phone
- (843) 790-4093
- Fax
- (843) 501-2297
- NPI assigned
- May 18, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 6491 | SC | Primary |
Addresses
Primary practice location
421 Barony St Ste 3
Moncks Corner, SC 29461-3145
Mailing address
940 E Estates Blvd Apt N
Charleston, SC 29414-5672
Phone (304) 616-2691
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6491 | SC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vantage Speech & Language LLC | Speech-Language Pathologist | Current | Accepting new patients |
| Vantage Early Intervention, LLC | Current | Accepting new patients |
Locations
421 Barony St
Ste 3
Moncks Corner, SC 29461
Phone (843) 513-4960
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Early Intervention Provider Agency
- Moncks Corner, SC
- NPI 1033941356
-
- Speech-Language Pathologist
- Moncks Corner, SC
- NPI 1063907731
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1495065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727308800000",
"number": "1508393752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "940 E ESTATES BLVD APT N",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294145672",
"telephone_number": "304-616-2691"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "421 BARONY ST STE 3",
"city": "MONCKS CORNER",
"state": "SC",
"postal_code": "294613145",
"telephone_number": "843-790-4093",
"fax_number": "843-501-2297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODRUFF",
"first_name": "LINDSEY",
"middle_name": "JEANNE",
"name_prefix": "Miss",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-18",
"last_updated": "2024-09-26",
"certification_date": "2024-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "SC",
"license": "6491",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Moncks Corner, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.