NPIMap

Organization Active NPI

Dietrich Speech & Language Services, LLC

  • Speech-Language Pathologist
  • Mount Pleasant, SC
National Provider Identifier
1760763718
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
DIETRICH SPEECH & LANGUAGE SERVICES, LLC
Practice address
3579 Franklin Tower Dr
Mount Pleasant, SC 29466-9383
Phone
(843) 810-9198
Fax
(855) 279-3149
NPI assigned
Sep 5, 2011
Last updated
Mar 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Authorized official

Name
Mrs. Kristen L. Dietrich, MS, CCC-SLPNPI 1295966794
Title
Owner, Speech-Language Pathologist
Phone
(843) 810-9198

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU Primary
Early Intervention Provider Agency 252Y00000X 4516 SC

Addresses

Primary practice location

3579 Franklin Tower Dr
Mount Pleasant, SC 29466-9383

Mailing address

3579 Franklin Tower Dr
Mount Pleasant, SC 29466-9383
Phone (843) 810-9198

Other identifiers 3

IdentifierTypeStateIssuer
30099867OtherSCMEDICAID - SELECT HEALTH
GP5764MedicaidSC
SA1113MedicaidSC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1315180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616371200000",
    "number": "1760763718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3579 FRANKLIN TOWER DR",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294669383",
            "telephone_number": "843-810-9198",
            "fax_number": "855-279-3149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3579 FRANKLIN TOWER DR",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294669383",
            "telephone_number": "843-810-9198",
            "fax_number": "855-279-3149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIETRICH SPEECH & LANGUAGE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-05",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A",
        "authorized_official_last_name": "DIETRICH",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER, SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "843-810-9198",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "SC",
            "license": "4516",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID - SELECT HEALTH",
            "identifier": "30099867",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP5764",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SA1113",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; 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.