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

Individual provider Speech-Language Pathologist · NPI 1750161808

Kelsey Jack, CCC-SLP is a Speech-Language Pathologist in Douglasville, Georgia. Licensed in Georgia and North Carolina. Registered with an NPI since 2023.

Licensed in
GA, NC
In the registry since
2023
Specialties on file
2
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

6078 Dorset Bridge Rd
Douglasville, GA 30135-6016
Phone: (361) 215-4254
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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 012517 (GA)
Speech-Language Pathologist Taxonomy 235Z00000X · Licence 30002182 (NC)

Record details

NPI number1750161808
Entity typeIndividual (Type 1)
GenderFemale
Credentials CCC-SLP
Sole proprietorNo
NPI enumeratedOctober 4, 2023
Last updated in NPPESOctober 4, 2023
Certification dateOctober 4, 2023
Mailing address6078 Dorset Bridge Rd, Douglasville, GA 30135-6016

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