Healthcare Provider Details

I. General information

NPI: 1205767449
Provider Name (Legal Business Name): CAITLIN S PHILLIPS MS CCC SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

432 4TH AVE SW
HICKORY NC
28602-2805
US

IV. Provider business mailing address

3218 DEERBROOK RD
LENOIR NC
28645-7001
US

V. Phone/Fax

Practice location:
  • Phone: 828-322-2855
  • Fax: 828-322-1834
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number14903
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: