Susan P Carroll, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP000907 Issued in GA

Practice address

5173 Eastbrook Rd
Douglasville, GA 30135-7436

Phone

(404) 403-9478

Fax

(770) 977-1582

NPI assigned

Sep 17, 2008

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

State licenses

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

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221609600000",
    "number": "1740439546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5173 EASTBROOK RD",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301357436",
            "telephone_number": "404-403-9478",
            "fax_number": "770-977-1582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5173 EASTBROOK RD",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301357436",
            "telephone_number": "404-403-9478",
            "fax_number": "770-977-1582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "SUSAN",
        "middle_name": "P",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-17",
        "last_updated": "2008-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP000907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Aminifu Sadifu Carr, PA
• Tesia Carroll, RBT
• David Carruth, CPS-AD
• Michelle Carruth, PT
• Brittany Carter, LCSW
• Marcus Gerard Carter

• Speech-Language Pathologist in Douglasville, GA
• Providers in Douglasville, 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 Sep 17, 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.