MEDICARE: MRS. LYNNE WASHINGTON STEVENS ME, CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	02546	MD
2	235Z00000X	Speech-Language Pathologist	2202002141	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	YC17LW	OTHER	MD	CAREFIRST BC/BS

General Provider Information

NPI Number	:	1093811507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LYNNE WASHINGTON STEVENS ME, CCC-SLP

Provider Business Mailing Address
First Line	:	315 COLESVILLE MANOR DR
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-1144
Country	:	US
Telephone Number	:	301-388-2211
Fax Number	:	301-388-2452

Provider Business Practice Location Address
First Line	:	315 COLESVILLE MANOR DR
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-1144
Country	:	US
Telephone Number	:	301-388-2211
Fax Number	:	301-388-2452

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	07/08/2007

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Directions to “ MRS. LYNNE WASHINGTON STEVENS ME, CCC-SLP” Practice Location

Language	Start Address	Practice Location

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