Healthcare Provider Details

I. General information

NPI: 1841818572
Provider Name (Legal Business Name): LEXIE MICHELLE RECENIELLO MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2020
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8335 NC 210 S
BUNNLEVEL NC
28323-8843
US

IV. Provider business mailing address

1008 S 11TH ST
LILLINGTON NC
27546-5929
US

V. Phone/Fax

Practice location:
  • Phone: 910-893-9153
  • Fax:
Mailing address:
  • Phone: 910-893-8151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number14211
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: