P Praxis·MD
● Active Type 1 · Individual

DR. Mary L. Duncan, CLINSCD CCC-SLP

Speech-Language Pathologist·Ellenwood, GA· NPI 1669537643 · Enumerated 2006 · 19 years on NPI
Duncan is 1 of 11 speech-language pathologist providers in Ellenwood and 1 of 5327 in Georgia.
NPI age
19 years
Enumerated 2006-12-27
Primary specialty
Speech-Language Pathologist
Plus 2 subspecialties
Licensed in
GA, VA, IL
3 states
Status
Active
No deactivations on record
Last NPPES update
2021-06-10
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
3 states
Top 95% — 4% of peers are multi-state
Subspecialties
0
9% of peers hold subspecialties

NPI lifetime · 2006 → 2026

2006-12Enumerated in NPPES
2006 2026

Where they practice

Practice location
4549 Revenue Trl
Ellenwood, GA 302946413
📞 4048052875fax 4047382128
Mailing address
4549 Revenue Trl
Ellenwood, GA 302946413
📞 4048052875fax 8669257840

Additional practice locations

1 secondary location on file with NPPES.

Location 2
7454 Hannover Pkwy S
Stockbridge, GA 302817889
📞 2295986660fax 4047382128

Specialties

  • Speech-Language Pathologist Primary
    The 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...
    GA license #6225VA license #2202009271IL license #146.011397 taxonomy 235Z00000X

Identifiers

TypeValueNotes
05 (GA) 410111878F
05 (GA) 410111878A
Multi-state credentialing: Licensed in 3 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.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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