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STACEY WALLEN PH. D., CCC-SLP
NPI 1376657114
Speech-Language Pathologist in Lithonia, GA

Active since August 18, 2006
3201 ROCKPORT DR, LITHONIA, GA 30038(954) 415-4069 Get Directions Write a Review

NPPES record last updated: April 8, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Stacey Wallen Ph. D., Ccc-slp NPPES

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

STACEY WALLEN PH. D., CCC-SLP (NPI 1376657114) is an individual speech-language pathologist provider in Lithonia, Georgia, licensed in Georgia (SLP006932) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1376657114
Entity TypeIndividualFemale
Primary Taxonomy235Z00000X
Provider Legal NameSTACEY WALLENCredential: PH. D., CCC-SLP
Location Address3201 ROCKPORT DRLithonia, GA 30038-1834
Mailing Address2209 Discovery Cir WDeerfield Beach, FL 33442-1006 · (954) 415-4069 · Fax (954) 596-0355
Phone(954) 415-4069
Sole ProprietorYes
Enumeration DateAugust 18, 2006
Last NPPES UpdateApril 8, 2014
✔ NPI 1376657114 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 · SLP006932✔ Licensed in FL · SA5662
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.
3201 ROCKPORT DR, Lithonia, GA 30038
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Other Identifiers 4

Medicaid003121866BGA
Medicaid8857075FL
OtherSA5662FL · State License Number
OtherSLP006932GA · Ga License Number

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 Stacey Wallen's NPI number?

The NPI number for Stacey Wallen is 1376657114. It was assigned to this individual provider in the NPPES registry on August 18, 2006.

Where is Stacey Wallen located?

Stacey Wallen practices at 3201 Rockport Dr, Lithonia, GA 30038. The listed phone number is (954) 415-4069.

What is Stacey Wallen's specialty?

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

When was this NPI record last updated?

The NPPES record for Stacey Wallen was last updated on April 8, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.