MEDICARE: DELTA SPEECH THERAPY LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QM1300X	Multi-Specialty Clinic/Center
2	104100000X	Social Worker
3	225X00000X	Occupational Therapist
4	251S00000X	Community/Behavioral Health Agency
5	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
6	251B00000X	Case Management Agency
7	252Y00000X	Early Intervention Provider Agency
8	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1659133783
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DELTA SPEECH THERAPY LLC

Provider Business Mailing Address
First Line	:	67 RED ROBIN TURN
Second Line	:
City	:	HAMPTON
State	:	VA
Zip	:	23669-5914
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	67 RED ROBIN TURN
Second Line	:
City	:	HAMPTON
State	:	VA
Zip	:	23669-5914
Country	:	US
Telephone Number	:	757-880-2468
Fax Number	:

Authorized Official
Title or Position	:	OWNER/THERAPIST
Name	:	JENNIFER JONES-HICKS
Credential	:
Telephone Number	:	757-880-2468

Provider Enumeration Date	:	01/24/2024
Last Update Date	:	09/16/2025

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