Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1124156435 Individual Practitioner Female Practitioner

Amanda Mizelle , MSCCC-SLP

Speech-Language Pathologist • Bolivia, NC

Professional Overview & Biography Verified Profile Summary

Amanda Mizelle, MSCCC-SLP is a registered healthcare professional specializing in Speech-Language Pathologist in Bolivia, NC. Practice services are available at 35 REFERENDUM DR NE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

35 Referendum Dr Ne

Bolivia, NC 284227578

Telephone 9104065100
Fax 8662930649
Associated Practice Facility / Clinic
🏢 Brunswick County Schools Facility NPI 1225158793

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Bolivia, NC

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 28.0 Yrs
State Avg: 15.0 Yrs
Regional Practice Density
22 Specialists

Practicing in Bolivia, NC (7242 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-03-31
Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License NC 2980

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 geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
7412516 (NC)
Medicaid State Provider ID
7212036 (NC)
Commercial Insurance / Payer ID Blue Cross Blue Shield
018CV (NC)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

23 Associated Practitioners
Jaclyn Oehler , MS, CCC-SLP

Speech-Language Pathologist

NPI 1114369683

Master of Science, Speech-Language Pathologist (Certificate of Clinical Competence)

Ryleigh Weber , MS

Speech-Language Pathologist

NPI 1114805132

Master of Science

Alison Slomba , OTR, L

Occupational Therapist

NPI 1134856610

Occupational Therapist Registered, L

Anita Bakula , SLP

Speech-Language Pathologist

NPI 1184719866

Speech-Language Pathologist

Selena Ehlert , OTR, L

Occupational Therapist

NPI 1194665919

Occupational Therapist Registered, L

Amy Randolph , MED, CCC-SLP

Speech-Language Pathologist

NPI 1295910057

Master of Education, Speech-Language Pathologist (Certificate of Clinical Competence)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location March 31, 2026

Registered at 35 REFERENDUM DR NE, BOLIVIA, NC 284227578 (Tel: 9104065100)

📍
Updated Business Mailing Address March 31, 2026

Registered at 2003 E OAK ISLAND DR STE 4, OAK ISLAND, NC 284656326 (Tel: 9198155046)

NPI Profile Active July 15, 2008

NPI status registered as active in NPPES database

📍
Updated Practice Location July 15, 2008

Registered at 4201 LAKE BOONE TRL, SUITE 4, RALEIGH, NC 276077512 (Tel: 9197814434)

📍
Updated Business Mailing Address July 15, 2008

Registered at 4201 LAKE BOONE TRL, SUITE 4, RALEIGH, NC 276077512 (Tel: 9197814434)

👤
Provider Name / Credentials Updated July 15, 2008

Recorded as AMANDA MIZELLE, M.S.CCC-SLP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 15, 2008

Speech-Language Pathologist (License #2980 in NC)

🟢
Initial NPI Registration & Enumeration February 28, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1124156435
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 28, 2007
Last Update: March 31, 2026
Sole Proprietor: No

Mailing Address

2003 E Oak Island Dr Ste 4

Oak Island, NC 284656326

Phone: 9198155046

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.