Healthcare Provider Details
I. General information
NPI: 1558138404
Provider Name (Legal Business Name): EMILY NICOLE WHITING M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/11/2023
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3041 BERKS WAY STE 203
RALEIGH NC
27614-6777
US
IV. Provider business mailing address
2604 FALLS RIVER AVE
RALEIGH NC
27614-9875
US
V. Phone/Fax
- Phone: 919-488-4009
- Fax: 984-272-2849
- Phone: 651-239-7881
- Fax: 984-272-2849
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | SLP.0006079 |
| License Number State | CO |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | 30004396 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: