Active NPI
Amy West Laviola, M.ED.
- Speech-Language Pathologist
- Canton, GA
National Provider Identifier
1891065397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 019539
- Practice address
- 115 Academy St Ste 102
Canton, GA 30114-3008 - Phone
- (404) 444-1521
- NPI assigned
- Dec 31, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | |||
| Speech-Language Pathologist | 235Z00000X | 019539 | NY | Primary |
Addresses
Primary practice location
115 Academy St Ste 102
Canton, GA 30114-3008
Mailing address
115 Academy St Ste 102
Canton, GA 30114-3008
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 Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019539 | NY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Simplicity Therapy Group Inc | Speech-Language Pathologist | Current | Accepting new patients |
Locations
115 Academy St
Ste 102
Canton, GA 30114
Phone (404) 390-2173
Organizations & group practices 1
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.
-
- Speech-Language Pathologist
- Canton, GA
- NPI 1134749336
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1325289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723161600000",
"number": "1891065397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 ACADEMY ST STE 102",
"city": "CANTON",
"state": "GA",
"postal_code": "301143008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 ACADEMY ST STE 102",
"city": "CANTON",
"state": "GA",
"postal_code": "301143008",
"telephone_number": "404-444-1521"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAVIOLA",
"first_name": "AMY",
"middle_name": "WEST",
"credential": "M.ED.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-31",
"last_updated": "2024-08-09",
"certification_date": "2024-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "019539",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Canton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.