Mallori Feazell, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7921 Issued in LA

Practice address

5201 Shreveport Hwy
Pineville, LA 71360-3527

Phone

(318) 640-3014

NPI assigned

Dec 1, 2020

Sex

Female

Sole proprietor

No

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 Science

State licenses

Practice roles

Locations

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.

• Synergy Care Southeast LLC

  • Physical Therapist
  • Lake Charles, LA
  • NPI 1891156055

  Speech-Language Pathologist

  NPD
• Synergy Care Southeast, LLC

  • Physical Therapist
  • Lake Charles, LA
  • NPI 1427466614

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1972108694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 WYSTERIA LN",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713604252",
            "telephone_number": "318-792-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 SHREVEPORT HWY",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713603527",
            "telephone_number": "318-640-3014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEAZELL",
        "first_name": "MALLORI",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "LA",
            "license": "7921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randy Scott Faecher, D.M.D.
• Rose Ann Faircloth, CAC
• Families Helping Families at the Crossroads
• Families Helping Families at the Crossroads
• Family Practice Associates
• Abby Lou Fennell, O.T.
• Daniel Thomas Ferreras, D.P.M.
• Honey Russell Fiasconaro, DDS
• Gary Bryan Fillette, M.D.
• First Round Medical Transportation LLC

• Speech-Language Pathologist in Pineville, LA
• Providers in Pineville, LA by specialty
• Speech-Language Pathologist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; 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.