Healthcare Provider Details

I. General information

NPI: 1528843737
Provider Name (Legal Business Name): MADELINE SHEA MCGINNIS CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: M. SHEA SWINGLE CCC-SLP

II. Dates (important events)

Enumeration Date: 08/28/2023
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44081 PIPELINE PLZ STE 120
ASHBURN VA
20147-5892
US

IV. Provider business mailing address

7039 SAUVAGE LN
GAINESVILLE VA
20155-1674
US

V. Phone/Fax

Practice location:
  • Phone: 703-723-7270
  • Fax:
Mailing address:
  • Phone: 571-208-7607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2202010865
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: