Individual provider Active NPI

Dana Statz Henning, M.A., CCC-S

  • Speech-Language Pathologist
  • Roswell, GA
National Provider Identifier
1710132998
Registry record updated Dec 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP000831 Issued in GA
Practice address
765 Birch Ridge Dr
Roswell, GA 30076-4607
Phone
(770) 664-9282
NPI assigned
Dec 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP000831 GA Primary

Addresses

Primary practice location

765 Birch Ridge Dr
Roswell, GA 30076-4607

Mailing address

765 Birch Ridge Dr
Roswell, GA 30076-4607
Phone (770) 664-9282

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
SLP000831GAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228089600000",
    "number": "1710132998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 BIRCH RIDGE DR",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764607",
            "telephone_number": "770-664-9282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 BIRCH RIDGE DR",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764607",
            "telephone_number": "770-664-9282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNING",
        "first_name": "DANA",
        "middle_name": "STATZ",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-01",
        "last_updated": "2008-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP000831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2008; 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.