Healthcare Provider Details

I. General information

NPI: 1487029807
Provider Name (Legal Business Name): STEPHANIE LOVELACE DONALDSON M.ED. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: STEPHANIE DONALDSON M.ED. CCC-SLP

II. Dates (important events)

Enumeration Date: 12/10/2015
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 RUSHTON DR
CHAPIN SC
29036-9843
US

IV. Provider business mailing address

120 RUSHTON DR
CHAPIN SC
29036-9843
US

V. Phone/Fax

Practice location:
  • Phone: 505-553-6444
  • Fax:
Mailing address:
  • Phone: 505-553-6444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP009092
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number9075
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number13728121-4102
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: