Active NPI
Marenda Kate Benson, M. ED CCC-SLP
- Speech-Language Pathologist
- Canton, GA
National Provider Identifier
1902335722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP009676
- Practice address
- 4280 Hickory Flat Hwy Ste 108
Canton, GA 30115-6634 - Phone
- (770) 345-2804
- Fax
- (770) 345-2804
- NPI assigned
- Jun 6, 2017
- 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 | SLP009676 | GA | Primary |
Addresses
Primary practice location
4280 Hickory Flat Hwy Ste 108
Canton, GA 30115-6634
Mailing address
280 Hickory Flat Hwy Ste 108
Canton, GA 30114
Phone (770) 345-2804
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 |
|---|---|---|---|
| SLP009676 | GA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496707200000",
"number": "1902335722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "280 HICKORY FLAT HWY STE 108",
"city": "CANTON",
"state": "GA",
"postal_code": "30114",
"telephone_number": "770-345-2804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4280 HICKORY FLAT HWY STE 108",
"city": "CANTON",
"state": "GA",
"postal_code": "301156634",
"telephone_number": "770-345-2804",
"fax_number": "770-345-2804"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENSON",
"first_name": "MARENDA",
"middle_name": "KATE",
"credential": "M. ED CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-06",
"last_updated": "2017-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "SLP009676",
"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 Jun 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.