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

Individual provider Speech-Language Pathologist · NPI 1669640603

Shannel Pickens, MS, CCC-SLP is a Qualified Speech Language Pathologist in Fayetteville, North Carolina. Qualified in 2011, 15 years ago. Practices with Legacy Healthcare Services Inc, a 3,624-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
15
Licensed in
TX
In the registry since
2008
What do these letters mean?
MS — Master of Science
A graduate science degree.
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

2919 Breezewood Ave Ste 101
Fayetteville, NC 28303-5283
Phone: (910) 484-1711
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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 108662 (TX)

Record details

NPI number1669640603
Entity typeIndividual (Type 1)
GenderFemale
Credentials MS , CCC-SLP
Sole proprietorYes
NPI enumeratedFebruary 12, 2008
Last updated in NPPESMay 12, 2022
Certification dateMay 12, 2022

Medicare enrollment

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

Medicare specialtyQUALIFIED SPEECH LANGUAGE PATHOLOGIST
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Legacy Healthcare Services Inc — 3624 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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