Mary Elizabeth Newstreet, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP005604 Issued in GA

Practice address

5667 Buttonwood CT
Stone Mountain, GA 30087-1611

Phone

(770) 891-2172

NPI assigned

May 11, 2014

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1399766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399766400000",
    "number": "1699186882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5667 BUTTONWOOD CT",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300871611",
            "telephone_number": "770-891-2172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5667 BUTTONWOOD CT",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300871611",
            "telephone_number": "770-891-2172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWSTREET",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-11",
        "last_updated": "2014-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP005604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Stone Mountain, GA
• Providers in Stone Mountain, 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 May 11, 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.