Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kacy Wickerson

Individual provider Speech-Language Pathologist · NPI 1831620855

Kacy Wickerson is a Speech-Language Pathologist in Charlotte, North Carolina. Practices as a sole proprietor and works from 2 locations. Licensed in Georgia, North Carolina and South Carolina.

Licensed in
GA, NC, SC
In the registry since
2017
Specialties on file
3
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Practice location Address checks out

11112 Scrimshaw Ln
Charlotte, NC 28215-8304
Phone: (704) 258-7031
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 11112 Scrimshaw Ln, Charlotte, NC 28215-8304 — (704) 258-7031

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 12381 (NC)
Speech-Language Pathologist Taxonomy 235Z00000X · Licence SLP011439 (GA)
Speech-Language Pathologist Taxonomy 235Z00000X · Licence 6006 (SC)

Record details

NPI number1831620855
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 22, 2017
Last updated in NPPESFebruary 7, 2022
Certification dateFebruary 3, 2022

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