Samantha Anne Tucker, M.A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP007905 Issued in GA

Practice address

3650 Highlands Pkwy SE
Smyrna, GA 30082-5184

Phone

(678) 305-9200

Fax

(678) 305-9201

NPI assigned

Oct 2, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Samantha Anne Sickels Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• North Paulding Speech Language Therapy LLC

  • Speech-Language Pathologist
  • Dallas, GA
  • NPI 1447691993
  NPD (past)
• North Paulding Speech Language Therapy LLC

  • Hearing and Speech Clinic/Center
  • Cartersville, GA
  • NPI 1982592754

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1380672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1871920124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 HIGHLANDS PKWY SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300825184",
            "telephone_number": "678-305-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 HIGHLANDS PKWY SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300825184",
            "telephone_number": "678-305-9200",
            "fax_number": "678-305-9201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5041 Dallas Hwy # 510",
            "address_purpose": "LOCATION",
            "city": "Powder Springs",
            "state": "GA",
            "postal_code": "301276458",
            "country_code": "US",
            "telephone_number": "678-653-7674",
            "fax_number": "678-653-7675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "SAMANTHA",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-02",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP007905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "SICKELS",
            "middle_name": "ANNE",
            "prefix": "MISS",
            "credential": "M.A., CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Robert Paul Truax Jr., D.C.
• True Glory Hair, LLC
• True Mind Connections Mental Health Services LLC
• True Path Home Care, LLC
• Margaret Anne Tucker, M.ED.,CCC-SLP
• Marc Turan
• Sterling Turmon
• Turner Therapies
• Camille Smith Turner, NP
• Jillian Turner, OTD

• Speech-Language Pathologist in Smyrna, GA
• Providers in Smyrna, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.