NPI age
19 years
Enumerated 2006-08-18
● Active
Type 1 · Individual
Stacey Wallen, PH. D., CCC-SLP
Wallen is 1 of 22 speech-language pathologist providers in Lithonia and 1 of 5327 in Georgia.
Primary specialty
Speech-Language Pathologist
Plus 1 subspecialty
Licensed in
GA, FL
2 states
Status
Active
No deactivations on record
Last NPPES update
2014-04-08
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 5327 active speech-language pathologist providers in Georgia.
NPI age
19 years
↑ 9 yr above median (10 yr)
State licenses
2 states
Top 95% — 4% of peers are multi-state
Subspecialties
0
9% of peers hold subspecialties
NPI lifetime · 2006 → 2026
2006-08Enumerated in NPPES
2006
2026
Where they practice
Practice location
3201 Rockport Dr
Lithonia, GA 300381834
Mailing address
2209 Discovery Cir W
Deerfield Beach, FL 334421006
Specialties
-
Speech-Language Pathologist PrimaryThe speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | SLP006932 | GA LICENSE NUMBER |
| 01 (FL) | SA5662 | STATE LICENSE NUMBER |
| 05 (GA) | 003121866B | |
| 05 (FL) | 8857075 |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
Recently enumerated nearby: 1 new speech-language pathologist provider has been added in Lithonia in the last 180 days.
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