Lauren Elizabeth Bazemore, MSP, CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Waynesboro, GA

NPI 1669955852 · NPPES record last updated Sep 13, 2018

Key facts

NPI
1669955852
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SLP010117 (GA)
Practice address
727 W 6TH St
Waynesboro, GA 30830-4407
Phone
(706) 592-5565
Fax
(706) 751-0825
NPI assigned
Sep 13, 2018
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
SLP010117GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Csra Therapy Services Inc Speech-Language Pathologist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP010117 GA Yes

Addresses

Primary practice location

727 W 6TH St
Waynesboro, GA 30830-4407

Mailing address

2312 1/2 Walton Way
Augusta, GA 30904-6124
Phone (912) 978-0564

Other providers in Waynesboro, GA

All providers in Waynesboro, GA · Speech-Language Pathologist in Georgia

Sources for this page

Verify at the official NPI Registry.