Alycia Bauch, MS, CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Calhoun, GA

NPI 1942435201 · NPPES record last updated Nov 11, 2020

Key facts

NPI
1942435201
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SLP008164 (GA)
Practice address
365 S Industrial Blvd
Calhoun, GA 30701-3075
Phone
(706) 624-3000
Fax
(706) 624-3001
NPI assigned
May 15, 2009
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SLP008164GAMDSpeech-Language Pathologist
41YS00403400NJMDSpeech-Language Pathologist
SL007286PAMDSpeech-Language Pathologist
6092SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Advance Rehabilitation for Kids of Gordon County, Inc Past
since Nov 15, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 41YS00403400 NJ
Speech-Language Pathologist 235Z00000X SL007286 PA
Speech-Language Pathologist 235Z00000X 6092 SC
Speech-Language Pathologist 235Z00000X SLP008164 GA Yes

Addresses

Primary practice location

365 S Industrial Blvd
Calhoun, GA 30701-3075

Mailing address

365 S Industrial Blvd
Calhoun, GA 30701-3075
Phone (706) 624-3000

Other identifiers

IdentifierTypeStateIssuer
SA1815MedicaidSC

Other names

  • Alycia Bauch Whitney Former name

Other providers in Calhoun, GA

All providers in Calhoun, GA · Speech-Language Pathologist in Georgia

Sources for this page

Verify at the official NPI Registry.