MEDICARE: KATE MAUREEN KELLEHER M.A., 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	7752	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	561850178	OTHER	NC	FED TAX ID
2	561850178	OTHER	NC	AMA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881890853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATE MAUREEN KELLEHER M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	536 OLD HOWELL RD
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29615-1969
Country	:	US
Telephone Number	:	828-357-2016
Fax Number	:	828-357-1098

Provider Business Practice Location Address
First Line	:	1 UNIVERSITY DR
Second Line	:
City	:	CULLOWHEE
State	:	NC
Zip	:	28723-9646
Country	:	US
Telephone Number	:	828-227-7251
Fax Number	:

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

Provider Enumeration Date	:	06/26/2007
Last Update Date	:	07/21/2022

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