Lynne J Willis, M.A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

3863 Issued in SC

Practice address

507 Watts Ave
Greenville, SC 29601-4357

Phone

(864) 313-1219

NPI assigned

Oct 19, 2006

Sex

Female

Sole proprietor

Yes

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

Practice roles

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.

• Small Talk Pediatric Speech Therapy, LLC

  • Speech-Language Pathologist
  • Greenville, SC
  • NPI 1134737331
  NPD Authorized official

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237507200000",
    "number": "1710069653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 WINDSOR DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296094741",
            "telephone_number": "864-242-4523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 WATTS AVE",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296014357",
            "telephone_number": "864-313-1219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "LYNNE",
        "middle_name": "J",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2009-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "3863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vonda Kay Williamson
• Crystal Williford
• Sophia Lila Willingham
• Brenda J Willis, LPN
• Kristen Britt Willis, RN
• Randi Meghan Willis, LMSW
• Terry A Willis, D.M.D.
• Willoughby Dental PA
• Willow Tree Counseling LLC
• Melanie H. Wills, M.D.

• Speech-Language Pathologist in Greenville, SC
• Providers in Greenville, SC by specialty
• Speech-Language Pathologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2009; 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.