Lauren Peterson, M.ED., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP009375 Issued in GA

Practice address

709 Crescent Cir
Canton, GA 30115-4772

Phone

(844) 543-8437

Fax

(844) 543-8437

NPI assigned

Aug 11, 2016

Last updated

Aug 11, 2016By the provider in NPPES

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 Education

State licenses

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

{
    "created_epoch": "1470873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470873600000",
    "number": "1740734359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 PENNSYLVANIA AVE",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302539110",
            "telephone_number": "844-543-8437",
            "fax_number": "844-543-8437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 CRESCENT CIR",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301154772",
            "telephone_number": "844-543-8437",
            "fax_number": "844-543-8437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "LAUREN",
        "credential": "M.ED., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-11",
        "last_updated": "2016-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP009375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dolly Chanta'E Penn, MD, MSCR
• Karen M Pennelli, P.A
• Manuel R Peralta
• Carolyn Perilli, RN
• Perimeter Anesthesia LLC
• Ryan Petrini, DC
• Steven D Peyroux, D.C.
• Fallan Pham-Reynolds
• John T Phelps, D.M.D.
• Stephen Matthew Phelps, D.M.D.

• Speech-Language Pathologist in Canton, GA
• Providers in Canton, 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 Aug 11, 2016; 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.