Active NPI
Lawanda Reese, M.S., CCC-SLP
- Speech-Language Pathologist
- Ellenwood, GA
National Provider Identifier
1790848901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP005435
- Practice address
- 4482 S River CV
Ellenwood, GA 30294-3281 - Phone
- (678) 438-9036
- Fax
- (404) 381-3043
- NPI assigned
- Dec 18, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP005435 | GA | Primary |
Addresses
Primary practice location
4482 S River CV
Ellenwood, GA 30294-3281
Mailing address
4482 S River CV
Ellenwood, GA 30294-3281
Phone (678) 438-9036
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00972573A | Medicaid | GA |
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP005435 | GA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1790848901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4482 S RIVER CV",
"city": "ELLENWOOD",
"state": "GA",
"postal_code": "302943281",
"telephone_number": "678-438-9036",
"fax_number": "404-381-3043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4482 S RIVER CV",
"city": "ELLENWOOD",
"state": "GA",
"postal_code": "302943281",
"telephone_number": "678-438-9036",
"fax_number": "404-381-3043"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REESE",
"first_name": "LAWANDA",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-18",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "SLP005435",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00972573A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ellenwood, GA
- Dolly S Rajamannar, OD
- Juna Gwendolyn Rankine
- Ahmari Shemari Rawls, DPT
- Reach Out Housing and Wellness Project Inc
- Alieizoria Redd, LCSW
- Rehabilitation Concepts, LLC
- Janette Reid, RN
- Reliable Medical Mobile Phlebotomy,LLC
- Resmedics Staffing and Medical Equipment Services
- Toni Simone Richardson, M.B.A, M.A, CCC-SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.