Provider Demographics
NPI:1699201731
Name:S.A.S. SPEECH, LLC
Entity Type:Organization
Organization Name:S.A.S. SPEECH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHIRIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARIFF
Authorized Official - Suffix:
Authorized Official - Credentials:MSR,CCC-SLP
Authorized Official - Phone:843-367-1975
Mailing Address - Street 1:1699 DEXTER LN
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-8660
Mailing Address - Country:US
Mailing Address - Phone:843-367-1975
Mailing Address - Fax:843-818-4896
Practice Address - Street 1:1699 DEXTER LN
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-8660
Practice Address - Country:US
Practice Address - Phone:843-367-1975
Practice Address - Fax:843-818-4896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-10
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSA0657235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSA0657Medicaid