NPIMap

Organization Active NPI

Heaven and Earth Speech Therapy

  • Speech-Language Pathologist
  • Fayetteville, GA
National Provider Identifier
1992376024
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
HEAVEN AND EARTH SPEECH THERAPY
Practice address
460 Hillsdale Dr
Fayetteville, GA 30214-1416
Phone
(970) 355-0012
NPI assigned
Jul 9, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Ashlee Gullickson, SLPNPI 1407425499
Title
Speech Language Pathologist
Phone
(970) 355-0012

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

460 Hillsdale Dr
Fayetteville, GA 30214-1416

Mailing address

460 Hillsdale Dr
Fayetteville, GA 30214-1416
Phone (970) 355-0012

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1625788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625788800000",
    "number": "1992376024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 HILLSDALE DR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141416",
            "telephone_number": "970-355-0012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 HILLSDALE DR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141416",
            "telephone_number": "970-355-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVEN AND EARTH SPEECH THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-09",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A",
        "authorized_official_last_name": "GULLICKSON",
        "authorized_official_first_name": "ASHLEE",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "970-355-0012",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2021; 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.