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1891858692

NPI Code Detail

MEDICARE: SPEECH AND LANGUAGE REHABILITATION SERVICES, INC.

MEDICARE: SPEECH AND LANGUAGE REHABILITATION SERVICES, INC.

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	2355S0801X	Speech-Language Assistant	SLP-A 0168	NC
2	235Z00000X	Speech-Language Pathologist	7693	NC
3	235Z00000X	Speech-Language Pathologist	7671	NC
4	235Z00000X	Speech-Language Pathologist	7899	NC
5	2355S0801X	Speech-Language Assistant	SLP-A 0058	NC
6	2355S0801X	Speech-Language Assistant	SLP-A 0036	NC
7	2355S0801X	Speech-Language Assistant	SLP-A 0064	NC
8	2355S0801X	Speech-Language Assistant	SLP-A 0021	NC
9	2355S0801X	Speech-Language Assistant	SLP-A 0103	NC
10	235Z00000X	Speech-Language Pathologist	2717	NC
11	235Z00000X	Speech-Language Pathologist	6808	NC
12	235Z00000X	Speech-Language Pathologist	6207	NC
13	251S00000X	Community/Behavioral Health Agency
14	235Z00000X	Speech-Language Pathologist	6950	NC
15	235Z00000X	Speech-Language Pathologist	932	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	0166Q	OTHER	NC	BCBS
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891858692
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPEECH AND LANGUAGE REHABILITATION SERVICES, INC.

Provider Business Mailing Address
First Line	:	PO BOX 1414
Second Line	:
City	:	CLINTON
State	:	NC
Zip	:	28329
Country	:	US
Telephone Number	:	910-299-0700
Fax Number	:	910-299-0800

Provider Business Practice Location Address
First Line	:	600 SUNSET AVE
Second Line	:
City	:	CLINTON
State	:	NC
Zip	:	28328-3946
Country	:	US
Telephone Number	:	910-299-0700
Fax Number	:	910-299-0800

Authorized Official
Title or Position	:	SPEECH PATHOLOGIST,PRESIDENT
Name	:	MRS. NELLIE HERRING HUDSON
Credential	:	MS, CCC,SLP
Telephone Number	:	910-299-0700

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	10/19/2011

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Practice Location Address:

600 SUNSET AVE
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28328-3946

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1811032055 — MRS. NELLIE HERRING HUDSON MS, CCC,SLP
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1477725216 — MRS. ASHLEY BUTLER MONTGOMERY M.ED,CFY/SLP
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1578735304 — MRS. KATE HUDSON SAUNDERS M.ED.,CFY/SLP
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1447423033 — MS. MARY ANN HONEYCUTT
Practice Location Address:

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1104099795 — CHASITY POPLIN
Practice Location Address:

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Directions to “SPEECH AND LANGUAGE REHABILITATION SERVICES, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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