Individual provider Active NPI

Elizabeth M Hicklin, CCC-SLP

  • Speech-Language Pathologist
  • Greenville, SC
National Provider Identifier
1831400076
Registry record updated Jun 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3619 Issued in SC
Practice address
136 E Tallulah Dr
Greenville, SC 29605-1141
Phone
(864) 630-9378
NPI assigned
Jun 22, 2010
Last updated
Jun 22, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2010

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 3619 SC Primary

Addresses

Primary practice location

136 E Tallulah Dr
Greenville, SC 29605-1141

Mailing address

136 E Tallulah Dr
Greenville, SC 29605-1141
Phone (864) 630-9378

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

LicenseStateTypeSpecialty
3619SCMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1277164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277164800000",
    "number": "1831400076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 E TALLULAH DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296051141",
            "telephone_number": "864-630-9378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 E TALLULAH DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296051141",
            "telephone_number": "864-630-9378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKLIN",
        "first_name": "ELIZABETH",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-22",
        "last_updated": "2010-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "3619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2010; 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.