Brightwalk Therapy Solutions, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

4895 Issued in NC

Legal business name

BRIGHTWALK THERAPY SOLUTIONS, LLC

Practice address

7415 Denali LN
Charlotte, NC 28216-5783

Phone

(704) 733-0986

Fax

(704) 978-8195

NPI assigned

Jul 17, 2014

Last updated

Jul 17, 2014By 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

Mrs. Latoya Cowan Breeden, MED.CCC/SLPNPI 1962694034

Title

Speech-Language Pathologist/Owner

Phone

(704) 733-0986

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Latoya Cowan Breeden, MED.CCC/SLP

  • Speech-Language Pathologist
  • Charlotte, NC
  • NPI 1962694034
  Authorized official Same address or phone

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

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405555200000",
    "number": "1568879955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7415 DENALI LANE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28216",
            "telephone_number": "704-733-0986",
            "fax_number": "704-978-8195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7415 DENALI LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282165783",
            "telephone_number": "704-733-0986",
            "fax_number": "704-978-8195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHTWALK THERAPY SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-17",
        "last_updated": "2014-07-17",
        "status": "A",
        "authorized_official_last_name": "BREEDEN",
        "authorized_official_first_name": "LATOYA",
        "authorized_official_middle_name": "COWAN",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST/OWNER",
        "authorized_official_telephone_number": "704-733-0986",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MED.CCC/SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "4895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Charlotte, NC
• Providers in Charlotte, 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 Jul 17, 2014; 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.