Marissa Joy Lee, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP10135 Issued in GA

Practice address

4212 Coral Park Dr
Brunswick, GA 31520

Phone

(912) 996-2069

Fax

(912) 265-0041

NPI assigned

Sep 5, 2017

Last updated

Jul 12, 2018By the provider in NPPES

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)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pediatric Therapies of SE Ga, LLC

  • Pediatric Occupational Therapist
  • Brunswick, GA
  • NPI 1841577111

  Speech-Language Pathologist

  NPD (past)
• The Speech & Swallowing Clinic, LLC

  dba The Therapy Tree

  • Hearing and Speech Clinic/Center
  • Douglas, GA
  • NPI 1306026497
  NPD (past)

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

{
    "created_epoch": "1504569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531353600000",
    "number": "1528586013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 PEARL AVE N",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315334632",
            "telephone_number": "912-331-0846",
            "fax_number": "678-792-4894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4212 CORAL PARK DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "31520",
            "telephone_number": "912-996-2069",
            "fax_number": "912-265-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MARISSA",
        "middle_name": "JOY",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-05",
        "last_updated": "2018-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP10135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED BASIC LIFE SUPPORT :CPR AND AED",
            "identifier": "GA00590",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECH PATHOLOGIST",
            "identifier": "SLP10135",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott Andrew Lederman, P.T.
• Colette E Lee-Lewis, MD
• Asianna Lee
• James J Lee, DO
• Laura Nichole Lee, MS
• Rachael Lee, LPC
• Legacy Hospice Ga, LLC (Coastal Hospice of Georgia)
• Paula J Legere, MD
• Erica Levine, PHARMD
• Herman Levy, M.D.

• Speech-Language Pathologist in Brunswick, GA
• Providers in Brunswick, 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 Jul 12, 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.