1841627056 NPI number — MRS. ELIZABETH YOPP SMITH MS, CCC-SLP

Table of content: MRS. ELIZABETH YOPP SMITH MS, CCC-SLP (NPI 1841627056)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841627056 NPI number — MRS. ELIZABETH YOPP SMITH MS, CCC-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SMITH
Provider First Name:
ELIZABETH
Provider Middle Name:
YOPP
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MS, CCC-SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
YOPP
Provider Other First Name:
ELIZABETH
Provider Other Middle Name:
MURRAY
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS, CCC-SLP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1841627056
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
900 S. FRANKLIN ST.
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
WAKE FOREST
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27587
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-556-1700
Provider Business Mailing Address Fax Number:
919-556-1245

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
900 S. FRANKLIN ST.
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
WAKE FOREST
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27587
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-556-1700
Provider Business Practice Location Address Fax Number:
919-556-1245
Provider Enumeration Date:
10/02/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  SLP.0001183 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 235Z00000X , with the licence number: 11011 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 720776G , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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