Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Keanna Nelson, CCC-SLP

Individual provider Speech-Language Pathologist · NPI 1386635191

Keanna Nelson, CCC-SLP is a Qualified Speech Language Pathologist in Fayetteville, Georgia. Qualified in 2004, 22 years ago. Practices as a sole proprietor. Licensed in Georgia.

Years since qualifying
22
Licensed in
GA
In the registry since
2005
What do these letters mean?
CCC-SLP — Certificate of Clinical Competence in Speech-Language Pathology
A speech-language pathologist certified by ASHA.

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Practice location Address checks out

175 Bradford Sq Ste A
Fayetteville, GA 30215
Phone: (678) 438-7168
Fax: (470) 377-8097
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence SLP006202 (GA)

Record details

NPI number1386635191
Entity typeIndividual (Type 1)
GenderFemale
Credentials CCC-SLP
Sole proprietorYes
NPI enumeratedNovember 1, 2005
Last updated in NPPESMay 16, 2025
Certification dateMay 16, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyQUALIFIED SPEECH LANGUAGE PATHOLOGIST
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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