Provider Demographics
NPI:1841662954
Name:SOUTHEASTERN COMMUNICATION AND SWALLOWING SPECIALISTS
Entity type:Organization
Organization Name:SOUTHEASTERN COMMUNICATION AND SWALLOWING SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:RINGLED
Authorized Official - Suffix:
Authorized Official - Credentials:MA-CCC-SLP
Authorized Official - Phone:910-705-1635
Mailing Address - Street 1:2039 MERRIMAC DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-2620
Mailing Address - Country:US
Mailing Address - Phone:910-705-1635
Mailing Address - Fax:
Practice Address - Street 1:2039 MERRIMAC DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-2620
Practice Address - Country:US
Practice Address - Phone:910-705-1635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-28
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10345235Z00000X
251E00000X, 251S00000X
NC9841235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health