Atlanta West Speech-Language Pathology and Associates, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP005812 Issued in GA

Legal business name

ATLANTA WEST SPEECH-LANGUAGE PATHOLOGY AND ASSOCIATES, LLC

Practice address

6732 Spring St
Douglasville, GA 30134-1760

Phone

(678) 901-7788

Fax

(866) 400-4772

NPI assigned

Jun 5, 2012

Organization subpart

No

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

Authorized official

Name

Dr. D'Jaris Renee White, PH.D,

Title

Speech-Language Pathologist

Phone

(678) 901-7788

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1338854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338854400000",
    "number": "1558622720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1950",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301331950",
            "telephone_number": "678-901-7788",
            "fax_number": "866-400-4772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6732 SPRING ST",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301341760",
            "telephone_number": "678-901-7788",
            "fax_number": "866-400-4772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTA WEST SPEECH-LANGUAGE PATHOLOGY AND ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-05",
        "last_updated": "2012-06-05",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "D'JARIS",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "678-901-7788",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D,"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP005812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2012; 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.