Rebecca C Ciccarelli, MS CCC/SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP008542 Issued in GA

Practice address

5865 Millwick Dr
Johns Creek, GA 30005-6733

Phone

(770) 559-0129

NPI assigned

Dec 19, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Rebecca C Loughlin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1198022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411516800000",
    "number": "1881878304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5865 MILLWICK DR",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300056733",
            "telephone_number": "770-559-0129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5865 MILLWICK DR",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300056733",
            "telephone_number": "770-559-0129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICCARELLI",
        "first_name": "REBECCA",
        "middle_name": "C",
        "credential": "MS CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-19",
        "last_updated": "2014-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "5123-SL",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP008542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "LOUGHLIN",
            "middle_name": "C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Speech-Language Pathologist in Johns Creek, GA
• Providers in Johns Creek, 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 Sep 24, 2014; 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.