Provider Demographics
NPI:1053939769
Name:GOLINOWSKI, ELEXEA NICHOLE (MA, CCC-SLP, CBIS)
Entity type:Individual
Prefix:
First Name:ELEXEA
Middle Name:NICHOLE
Last Name:GOLINOWSKI
Suffix:
Gender:F
Credentials:MA, CCC-SLP, CBIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3431 DORADO CIR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-0627
Mailing Address - Country:US
Mailing Address - Phone:330-719-1675
Mailing Address - Fax:
Practice Address - Street 1:3431 DORADO CIR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-0627
Practice Address - Country:US
Practice Address - Phone:330-719-1675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-09
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL61440699235Z00000X
GASLP013421235Z00000X
NC13987235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist