MRS. MAVIS D IVY (M.A., CCC-SLP) – Speech-Language Pathologist, NPI 1164659421

MRS. MAVIS D IVY (M.A., CCC-SLP) is a healthcare provider. based in Dunwoody, Georgia. specializing in Speech-Language Pathologist. They hold the professional credentials M.A., CCC-SLP. They hold a License No. 001672 (GA). The NPI Number for MRS. MAVIS D IVY (M.A., CCC-SLP) is 1164659421

Main info

Female
Sole Proprietor
51 Years Of Experience
Accepts Medicare Assignment
Name
MRS. MAVIS D IVY (M.A., CCC-SLP)
NPI
1164659421
Phone
(678) 592-0052
Address
5338 BRIARLEIGH CLOSE
Enumeration Date
14 June 2009
Last Update Date
14 June 2009

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8445027996
Graduation Year
1975 (51 years ago)
PAC ID
4082763859
Group Practice PAC ID
4284063835
Professional Enrollment ID
I20171120002155
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:17State licenses:1Digital endpointsOther names

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Provider Addresses for MRS. MAVIS D IVY (M.A., CCC-SLP)

  • 5338, Briarleigh Close, Waterford, Dunwoody, DeKalb County, Georgia, 30338, United States

    DUNWOODY, GA 303387006

    Phone: (678) 592-0052

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

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No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30338)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4284063835View full group profile
NameSpecialtyState
Occupational Therapist In Private PracticeGA
-GA
Qualified Speech Language PathologistGA
Occupational Therapist In Private PracticeGA
-GA
Qualified Speech Language PathologistGA
Occupational Therapist In Private PracticeAL
Occupational Therapist In Private PracticeGA
Qualified Speech Language PathologistMD
Physical Therapist In Private PracticeGA

Reviews

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Frequently asked questions

What unique ID ties claims to MRS. MAVIS D IVY (M.A., CCC-SLP)?
NPI 1164659421 is assigned to MRS. MAVIS D IVY (M.A., CCC-SLP) under the national enumeration system.
Is MRS. MAVIS D IVY (M.A., CCC-SLP)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize MRS. MAVIS D IVY (M.A., CCC-SLP)'s specialty in plain language?
Clinically, the directory lists MRS. MAVIS D IVY (M.A., CCC-SLP) with Speech-Language Pathologist. Clinical services aligned with this taxonomy classification.
Does MRS. MAVIS D IVY (M.A., CCC-SLP) practice in Georgia?
You will see Dunwoody, Georgia on file for MRS. MAVIS D IVY (M.A., CCC-SLP) alongside any extra practice locations.
How can I contact MRS. MAVIS D IVY (M.A., CCC-SLP)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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