MEDICARE: ELIZABETH LEAVITT MS, 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	2204000876	VA
2	235Z00000X	Speech-Language Pathologist	220201168	VA

General Provider Information

NPI Number	:	1285371666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH LEAVITT MS, CCC-SLP

Provider Business Mailing Address
First Line	:	9964 HONEY MEADOWS RD
Second Line	:
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23116-2603
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9964 HONEY MEADOWS RD
Second Line	:
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23116-2603
Country	:	US
Telephone Number	:	804-601-6010
Fax Number	:

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

Provider Enumeration Date	:	05/17/2022
Last Update Date	:	05/06/2026

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Directions to “ ELIZABETH LEAVITT MS, CCC-SLP” Practice Location

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