Active NPI
Lacey Donn Mollohan
- Speech-Language Pathologist
- Rocky Mount, NC
National Provider Identifier
1801466842
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 14660
- Practice address
- 160 S Winstead Ave # 3419
Rocky Mount, NC 27804-3419 - Phone
- (252) 443-7666
- NPI assigned
- Jul 1, 2021
- Sex
- Female
- Sole proprietor
- No
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 | 14660 | NC | Primary |
Addresses
Primary practice location
160 S Winstead Ave # 3419
Rocky Mount, NC 27804-3419
Mailing address
10947 Connally LN
Raleigh, NC 27614-8337
Phone (828) 320-3547
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14660 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625097600000",
"number": "1801466842",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10947 CONNALLY LN",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276148337",
"telephone_number": "828-320-3547"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 S WINSTEAD AVE # 3419",
"city": "ROCKY MOUNT",
"state": "NC",
"postal_code": "278043419",
"telephone_number": "252-443-7666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOLLOHAN",
"first_name": "LACEY",
"middle_name": "DONN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-01",
"last_updated": "2021-07-01",
"certification_date": "2021-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "14660",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rocky Mount, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.