MEDICARE: NEUROWISE SPEECH THERAPY

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	261QH0700X	Hearing and Speech Clinic/Center

General Provider Information

NPI Number	:	1265310411
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEUROWISE SPEECH THERAPY

Provider Business Mailing Address
First Line	:	2650 SENEGAL WAY SW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30331-3147
Country	:	US
Telephone Number	:	910-273-6693
Fax Number	:

Provider Business Practice Location Address
First Line	:	2650 SENEGAL WAY SW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30331-3147
Country	:	US
Telephone Number	:	910-273-6693
Fax Number	:

Authorized Official
Title or Position	:	SLP
Name	:	CHELSEA MARIE UNDERWOOD
Credential	:	M.A CCC
Telephone Number	:	910-273-6693

Provider Enumeration Date	:	08/25/2025
Last Update Date	:	08/25/2025

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Directions to “NEUROWISE SPEECH THERAPY ” Practice Location

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