MEDICARE: LAUREN R HASTINGS CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	8460	GA

General Provider Information

NPI Number	:	1245599414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN R HASTINGS CCC-SLP

Provider Business Mailing Address
First Line	:	1034 MAIN ST # 331
Second Line	:
City	:	GARDENDALE
State	:	AL
Zip	:	35071-3484
Country	:	US
Telephone Number	:	404-550-9458
Fax Number	:

Provider Business Practice Location Address
First Line	:	1800 PHOENIX BLVD
Second Line	:	SUITE 128-17 #1077
City	:	ATLANTA
State	:	GA
Zip	:	30349
Country	:	US
Telephone Number	:	470-470-8946
Fax Number	:	470-222-2765

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2012
Last Update Date	:	01/12/2025

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Directions to “ LAUREN R HASTINGS CCC-SLP” Practice Location

Language	Start Address	Practice Location

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