Geraldine Glenn, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

4663 Issued in SC

Practice address

300 W Washington St
Winnsboro, SC 29180

Phone

(803) 718-1680

NPI assigned

Sep 26, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1922583970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 133",
            "city": "WINNSBORO",
            "state": "SC",
            "postal_code": "291800133",
            "telephone_number": "803-718-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W WASHINGTON ST",
            "city": "WINNSBORO",
            "state": "SC",
            "postal_code": "29180",
            "telephone_number": "803-718-1680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7490 Parklane Rd",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292237618",
            "country_code": "US",
            "telephone_number": "803-718-1680",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5306 N Main St",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292036114",
            "country_code": "US",
            "telephone_number": "803-718-1680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLENN",
        "first_name": "GERALDINE",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-26",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "4663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Winnsboro, SC
• Providers in Winnsboro, SC by specialty
• Speech-Language Pathologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; 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.