Healthcare Provider Details

I. General information

NPI: 1871409466
Provider Name (Legal Business Name): HALLIE GOLDSTEIN CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5425 WISCONSIN AVE STE 600
CHEVY CHASE MD
20815-3588
US

IV. Provider business mailing address

5425 WISCONSIN AVE STE 600
CHEVY CHASE MD
20815-3588
US

V. Phone/Fax

Practice location:
  • Phone: 301-986-1503
  • Fax:
Mailing address:
  • Phone: 301-986-1503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP100745
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP200001821
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number12152
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: