1. Home
  2. Directory
  3. Georgia
  4. Clayton
  5. Speech Language Pathologist
  6. NPI Profile

MRS. DESTINY MILLER MANGAN M.S. CCC-SLP
NPI 1245982289
Speech-Language Pathologist in Clayton, GA

Active since January 20, 2022
165 RIDGECREST CIR, CLAYTON, GA 30525(678) 357-5849 Get Directions Write a Review

NPPES record last updated: January 1, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 1, 2024, Jan 20, 2022 (2 updates tracked since 2022).

About Mrs. Destiny Miller Mangan M.s. Ccc-slp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. DESTINY MILLER MANGAN M.S. CCC-SLP (NPI 1245982289) is an individual speech-language pathologist provider in Clayton, Georgia, licensed in Georgia (SLP012443) and active in the NPI registry since January 2022.

NPPES Registry Identity

NPI1245982289
Entity TypeIndividualFemale
Primary Taxonomy235Z00000X
Provider Legal NameMRS. DESTINY MILLER MANGANCredential: M.S. CCC-SLP
Location Address165 RIDGECREST CIRClayton, GA 30525-4110
Mailing Address165 Ridgecrest CirClayton, GA 30525-4110 · (678) 357-5849
Phone(678) 357-5849
Sole ProprietorYes
Enumeration DateJanuary 20, 2022
Last NPPES UpdateJanuary 1, 20242 updates tracked since enumeration
NPPES CertifiedJanuary 1, 2024
✔ NPI 1245982289 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
Licenses✔ Licensed in GA · SLP012443✔ Licensed in GA · PCET003509
Definition
The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.
165 RIDGECREST CIR, Clayton, GA 30525
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Destiny Miller Mangan M.s. Ccc-slp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Destiny Mangan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Fundamental Therapy Services, LLC
Same address
Occupational Therapist
165 RIDGECREST CIR
Clayton, GA 30525
  • Reassigned Medicare billing, Georgia enrollment
  • 4 clinicians in this Medicare group
NPI 1780110155 (678) 357-5849

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. JAMIE LYNN NASH MS, OTR/L
Occupational Therapist (Pediatrics)
165 RIDGECREST CIR
CLAYTON, GA 30525
Rabun County (678) 357-5849
ANNE REED RICKMAN M.ED., CCC-SLP
Speech-Language Pathologist
165 RIDGECREST CIR
CLAYTON, GA 30525
Rabun County (706) 782-6330
KAITLYN HOWELL PT, DPT
Physical Therapist (Pediatrics)
165 RIDGECREST CIR
CLAYTON, GA 30525
Rabun County (678) 357-5849
DANNY STEVENS HAMMONS
Durable Medical Equipment & Medical Supplies (Oxygen Equipment & Supplies)
165 RIDGECREST CIR, B
CLAYTON, GA 30525
Rabun County (706) 782-6199
MIRANDA RAE HUNNICUTT
Speech-Language Pathologist
165 RIDGECREST CIR
CLAYTON, GA 30525
Rabun County (678) 357-5849
FUNDAMENTAL THERAPY SERVICES, LLC
Occupational Therapist
165 RIDGECREST CIR
CLAYTON, GA 30525
Rabun County (678) 357-5849

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Destiny Mangan's NPI number?

The NPI number for Destiny Mangan is 1245982289. It was assigned to this individual provider in the NPPES registry on January 20, 2022.

Where is Destiny Mangan located?

Destiny Mangan practices at 165 Ridgecrest Cir, Clayton, GA 30525. The listed phone number is (678) 357-5849.

What is Destiny Mangan's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Is Destiny Mangan enrolled in Medicare?

Yes. Destiny Mangan is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Destiny Mangan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Destiny Mangan reassigns Medicare benefits to Fundamental Therapy Services, LLC (Clayton, GA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Destiny Mangan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Destiny Mangan was last updated on January 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.