Healthcare Provider Details

I. General information

NPI: 1942930904
Provider Name (Legal Business Name): ELI LITVACK M.A., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2022
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 MEDICAL PARK DR
MARSHALL NC
28753-6807
US

IV. Provider business mailing address

14 DOGWOOD CT APT A
ASHEVILLE NC
28805-2366
US

V. Phone/Fax

Practice location:
  • Phone: 828-649-2705
  • Fax:
Mailing address:
  • Phone: 908-514-7250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number031850
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number30001462
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number6924
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: