Chyan A. Black
NPI 1396569687ActiveIndividual· Speech-Language Pathologist· Dacula, GA
Speech-Language Pathologist in Dacula, Georgia, licensed in GA, with an NPI issued in November 2024. Enrolled in Medicare as practitioner - qualified speech language pathologist.
Overview
| NPI | 1396569687 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Nov 13, 2024 |
| Last updated in NPPES | Nov 13, 2024 |
| Certified by provider | Nov 13, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Speech-Language Pathologist Primary | 235Z00000X | PCET004159 | GA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Qualified Speech Language Pathologist (IL) |
|---|
Education and affiliations
| Graduation year | 2024 |
|---|---|
| Medicare specialty | Qualified Speech Language Pathologist |
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All 60 speech-language pathologists in Dacula · All speech-language pathologists in Georgia