Individual provider Active NPI

Susan Haviland, MA CCC-SLP

  • Speech-Language Pathologist
  • Alpharetta, GA
National Provider Identifier
1790143352
Registry record updated Feb 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP004513 Issued in GA
Practice address
555 Owens Farm Rd
Alpharetta, GA 30004-7300
Phone
(248) 894-2024
NPI assigned
Feb 10, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2016

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 SLP004513 GA Primary

Addresses

Primary practice location

555 Owens Farm Rd
Alpharetta, GA 30004-7300

Mailing address

555 Owens Farm Rd
Alpharetta, GA 30004-7300
Phone (248) 894-2024

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
SLP004513GAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1455062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455062400000",
    "number": "1790143352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 OWENS FARM RD",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300047300",
            "telephone_number": "248-894-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 OWENS FARM RD",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300047300",
            "telephone_number": "248-894-2024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVILAND",
        "first_name": "SUSAN",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-10",
        "last_updated": "2016-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP004513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

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