Individual provider Active NPI

Amalia Vlachos, MA CCC-SLP

  • Speech-Language Pathologist
  • Kennesaw, GA
National Provider Identifier
1730494139
Registry record updated Aug 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP007049 Issued in GA
Practice address
3105 Creekside Village Dr NW
Suite 603
Kennesaw, GA 30144-2394
Phone
(770) 974-2424
NPI assigned
Aug 10, 2010
Last updated
Aug 10, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2010

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 SLP007049 GA Primary

Addresses

Primary practice location

3105 Creekside Village Dr NW
Suite 603
Kennesaw, GA 30144-2394

Mailing address

633 Vickery Way NE
Marietta, GA 30066-4815
Phone (770) 425-2578

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
SLP007049GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Milestone Therapy LLC Speech-Language Pathologist Past Accepting new patients
Dynamic Therapy Associates, Inc Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1281398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281398400000",
    "number": "1730494139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 VICKERY WAY NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300664815",
            "telephone_number": "770-425-2578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 CREEKSIDE VILLAGE DR NW",
            "address_2": "SUITE 603",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301442394",
            "telephone_number": "770-974-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VLACHOS",
        "first_name": "AMALIA",
        "name_prefix": "Mrs.",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-10",
        "last_updated": "2010-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP007049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2010; 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.