Speech Evolve Therapy Services, Limited Liability Company

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

SPEECH EVOLVE THERAPY SERVICES, LIMITED LIABILITY COMPANY

Practice address

3980 Ambrose Ridge CT
Ellenwood, GA 30294-6257

Phone

(404) 484-8685

NPI assigned

May 10, 2020

Organization subpart

No

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

Authorized official

Name

Miss Jessica Cierra Co, CCC-SLP

Title

Owner/ Speech Therapist

Phone

(404) 484-8685

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.

• Jessica Cox

  • Speech-Language Pathologist
  • Ellenwood, GA
  • NPI 1093375149
  NPD

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

{
    "created_epoch": "1589068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589068800000",
    "number": "1720600083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3980 AMBROSE RIDGE CT",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302946257",
            "telephone_number": "404-484-8685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3980 AMBROSE RIDGE CT",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302946257",
            "telephone_number": "404-484-8685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEECH EVOLVE THERAPY SERVICES, LIMITED LIABILITY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-10",
        "last_updated": "2020-05-10",
        "certification_date": "2020-05-10",
        "status": "A",
        "authorized_official_last_name": "CO",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "CIERRA",
        "authorized_official_title_or_position": "OWNER/ SPEECH THERAPIST",
        "authorized_official_telephone_number": "404-484-8685",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Ellenwood, GA
• Providers in Ellenwood, 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 10, 2020; 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.